Cerebral venous thrombosis with secondary intracranial hypertension

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Severe headaches with visual disturbances.

Patient Data

Age: 30 years
Gender: Female

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-visualized 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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