Cerebral venous infarction

Case contributed by Dr Md Imdadul Islam

Presentation

Headache and right-sided weakness

Patient Data

Age: 30 years
Gender: Female
MRI

A lesion in the left parietal lobe is hyperintense on both T1 and T2WI, with perilesional edema. The lesion shows diffusion restriction and signal loss on SWI. The right sigmoid sinus, transverse sinus, and posterior aspect of the superior sagittal sinus, as well as the cortical vein over the left parietal lobe, are expanded and are T1 hyperintense. On MRV, the right sigmoid sinus, transverse sinus, and superior sagittal sinus are not visualized.

Case Discussion

T1/T2 hyperintense lesion involving the cortical and subcortical region of the left parietal lobe showing signal dropout on SWI, suggest late subacute hematoma. Thrombosis involving right sigmoid sinus, transverse sinus, and superior sagittal sinus. Thrombus also noted involving cortical vein over the left parietal lobe. The above mentions features are consistent with cerebral venous thrombosis with venous infarct.

Other differential diagnoses are neoplasm with intratumoral hemorrhage, cerebral contusion in the setting of trauma, and lobar hemorrhage due to amyloid angiopathy.

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