Cerebral venous infarction

Case contributed by Mohammad A. ElBeialy

Presentation

Sudden onset of severe headache and dizziness with vomiting.

Patient Data

Age: 55 years
Gender: Female
mri

A left temporo-occipital cortical and subcortical area of low T1, high T2 and FLAIR signals with restricted diffusibility showing high DW and low ADC signal.

The left jugular vein as well as the left sigmoid and transverse sinuses appear distended with hyperintense signal within. 

Left otomastoiditis with T2 prolongation. 

Few left frontal subcortical and bilateral pontine small ovoid foci of bright T2 / FLAIR signals are seen.  

mri

The patient underwent MRV brain which confirmed venous sinus thrombosis. Axial T2 of the brain showed enlarging left temporo-occipital subacute hemorrhagic venous infarction

Case Discussion

Diagnosis:

  • left temporo-occipital cortical and subcortical acute hemorrhagic venous infarction with acute left IJV, sigmoid sinus and transverse sinuses thrombosis mostly 2ry to left otomastoiditis
  • left frontal subcortical and bilateral pontine small ischemic foci

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