Cerebral venous thrombosis - CT only

Case contributed by Dr Bruno Di Muzio

Presentation

Headaches for 5 days, no improvement after medication.

Patient Data

Age: 29-year-old
Gender: Female

CT Brain

Modality: CT

Technique: Volumetric non-contrast axial images have been obtained through the brain.

Findings: There is a heterogeneous hyperdensity in the sinus confluence and along the left transverse venous sinus associated with a slight hypoattenuation along the adjacent occipital lobe parenchyma (cortical oedema). There is also a dense strip along the tentorium cerebelli that may correspond to a superficial vein thrombosis; it is hard to define if there are some cortical linear density. The remainder brain parenchyma is unremarkable. Ventricular system is normal for the age group.

Conclusion: Left transverse venous sinus thrombosis with signs of associated adjacent cortical oedema.

Modality: Annotated image

Yellow arrows showing the dense left transverse venous sinus and the sinus confluence. Red arrow spotting the subtle adjacent parenchyma hypoattenuation. 

Case Discussion

Unfortunately, we didn't have access to further brain imaging in this patient. The diagnosis is based only on the clinical history and typical CT radiographic features for dural venous sinus thrombosis

CT and CT venogram can diagnosis venous thrombosis, however, they are less sensitive for assessing venous infarct. 

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Case Information

rID: 41031
Case created: 12th Nov 2015
Last edited: 18th Nov 2015
Inclusion in quiz mode: Included

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