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Dural venous sinus thrombosis (MRI)

Case contributed by Andrei Dumitrescu
Diagnosis almost certain

Presentation

Headaches and hemisensory syndrome on the left side.

Patient Data

Age: 60 years
Gender: Male

Non-enhanced T1 and T2-weighted imaging demonstrate hyperintense thrombus in the posterior sagittal sinus as well as the transverse and sigmoid sinus on the right, extending into the upper right jugular vein. ADC map shows hypointensity of the thrombus relative to normal white matter. There is also a thin, subacute subdural hematoma over both cerebral hemispheres without significant mass effect.

Case Discussion

This patient presented with headaches and a hemisensory syndrome on the left side, denying any recent trauma. While headaches are frequent manifestations of both sinus vein thrombosis and subdural hemorrhage, neurologic deficits are inconstant and highly variable. A history of head trauma is frequently absent.

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