Cerebral venous thrombosis with secondary intracranial hypertension
Diagnosis almost certain
Presentation
Severe headaches with blurred vision. No fever or ear pain.
Patient Data
Age: 40 years
Gender: Male
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The MRI sequences demonstrate a partial thrombosis of the superior and inferior sagittal sinuses as well as the sigmoid and lateral sinuses extending to the jugular bulb on the right. The intraluminal clots show an intermediate to high signal on T1, high signal on T2 and FLAIR. No associated parenchymal venous infarction is seen.
Signs of secondary intracranial hypertension are well-visualized on axial T2 fat saturation:
- vertical tortuosity of the optic nerves
- mild enlarged subarachnoid space around the optic nerves
- flattening of the posterior sclera bilaterally with mild intraocular protrusion of the optic nerve head mainly on the left
- enlargement of the Meckel cave
Right mastoid air cells effusion with no apparent bony destruction (an ENT examination was requested).
Case Discussion
MRI features of a cerebral venous thrombosis (CVT) with secondary intracranial hypertension.