Cerebral venous infarction

Case contributed by Dr Mostafa El-Feky

Presentation

Headache and convulsions.

Patient Data

Age: 65 years
Gender: Male
MRI

A rather defined intra-axial lesion is noted at the right temporal lobe. It displays T2 and FLAIR hyperintense signal with hypointense rim and T1 heterogenous hyperintense signal. No appreciable post contrast enhancement. On SWI evident blooming seen demoting hemorrhagic changes.

This is associated with mild perifocal edema and mass effect manifested as effacement of the related cortical sulci and occipital horn of the right lateral ventricle.

Thin rim extra-axial hemorrhage about 4 mm seen at the right temporoparietal region. 

Mild age-related involutional brain changes. 

MRV

MRI

Thrombosis of the right transverse sinus and sigmoid sinuses.

Case Discussion

MRI features are suggestive of sizable right temporal lobe late subacute hemorrhagic venous infarction sequel to homolateral transverse and sigmoid sinuses thrombosis. Temporoparietal regions are usually affected in transverse / sigmoid sinus thrombosis-related venous infarction.

Venous thrombosis should be considered in the assessment of confluent infarct or hemorrhage in atypical areas, crossing arterial territories, or infarcts with cortical sparing 1

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.