Cerebral venous thrombosis with secondary intracranial hypertension
Diagnosis almost certain
Presentation
Severe headaches with visual disturbances.
Patient Data
Age: 30 years
Gender: Female
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The MRI sequences demonstrate a thrombosis of the superior sagittal sinus as well as the left sigmoid/lateral sinuses and the ipsilateral internal jugular vein. The intraluminal clots are of intermediate to high signal on T1 and T2 and high signal on FLAIR with loss of their signal on gradient echo. No associated parenchymal venous infarction is seen.
signs of secondary intracranial hypertension are well-visualised on axial T2 fat saturation:
- vertical tortuosity of the optic nerves
- enlarged subarachnoid space around the optic nerves
- flattening of the posterior sclera bilaterally
- intraocular protrusion of the optic nerve head mainly on the left
- moderate enlargement of the Meckel cave
Case Discussion
MRI features of a cerebral venous thrombosis with secondary intracranial hypertension.
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