Cerebral venous thrombosis - CT only

Case contributed by Bruno Di Muzio
Diagnosis almost certain

Presentation

Headaches for 5 days, no improvement after medication.

Patient Data

Age: 29-year-old
Gender: Female

CT Brain

ct
This study is a stack
Axial
non-contrast
This study is a stack
Sagittal
non-contrast
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Info

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 edema). 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 edema.

Annotated image
Axial
non-contrast
Axial
non-contrast
Download
Info

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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