Dural venous sinus thrombosis

Case contributed by Dr Matthew Lukies

Presentation

New onset left sided hemiparesis. Query stroke or migraine.

Patient Data

Age: 35 years
Gender: Female
CT
  • Hyperattenuation of the torcula, right transverse and sigmoid sinuses through to the right internal jugular vein on non-IV contrast CT
  • Linear filling defects of the torcula, right transverse and sigmoid sinuses through to the right internal jugular vein
  • Further filling defect in the superior sagittal sinus at the vertex
  • Right posterior fossa arachnoid cyst
MRI
  • Venous sinus thrombosis involving the superior sagittal sinus, adjacent cortical veins, right transverse sinus and right sigmoid sinus
  • FLAIR hyperintensity and susceptibility artefact in the central sulcus and bilateral occipital / posterior temporal lobes, consistent with subarachnoid hemorrhage
  • No established infarct
  • Right posterior fossa arachnoid cyst

Case Discussion

Findings in this case are consistent with dural venous sinus thrombosis, with a dense vein sign shown on initial non-IV contrast brain CT.

The patient in this case was treated with long term anticoagulation and optimization of hormonal contraceptive (lower estrogen dose) to minimize future risk.

PlayAdd to Share

Case information

rID: 80376
Published: 22nd Jul 2020
Last edited: 22nd Jul 2020
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.