Haemorrhagic venous infarct

Case contributed by RMH Core Conditions

Presentation

Found GCS 13 after not being seen for a few days.

Patient Data

Age: 72
Gender: Female
Modality: CT

Large left intracranial haemorrhage measures up to 53 x 37 mm, and involves the frontal, parietal and temporal lobes, with surrounding vasogenic oedema. No subarachnoid or ventricular blood is detected. Significant mass effect, with 7 mm of subfalcine herniation to the right, and effacement of the left lateral ventricle, Sylvian fissure and cortical sulci. No transtentorial or uncal herniation.

 

Modality: MRI

A large (6 x 3 x 4 cm) left temporal lobe intra axial lesion demonstrates heterogenous T2 signal, peripheral T1 hyperintensity, and marked T2*GRE susceptibility artefact.

The lesion exerts significant local mass effect with surrounding sulcal effacement. Secondary subfalcine and early transtentorial brain herniation; right subfalcine midline shift (5 mm), mesial temporal lobe shift and cerebral peduncle compression, and mid brain shift.

The left transverse sinus is brightly T1 and T2 hyperintense and the phase-contrast MRV demonstrates complete absence of flow.

Conclusion

Left transverse sinus thrombosis. Associated left temporal lobe haemorrhagic venous infarct with significant mass effect and brain herniation.

 

PlayAdd to Share

Case Information

rID: 34052
Case created: 3rd Feb 2015
Last edited: 10th Sep 2015
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

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

Alert accept Thank you for updating your details.