Internal jugular vein thrombosis

Case contributed by Dr Bruno Di Muzio

Presentation

Postoperative imaging of right posterior fossa acoustic schwannoma. Asymptomatic.

Patient Data

Age: 60-year-old
CT

CT Brain

Translabyrinthine approach craniotomy and resection of the right acoustic neuroma noted with expected postoperative changes, including a small amount of pneumocephalus. Grey-white matter differentiation is preserved. Ventricles and basal cisterns are normal. No midline shift or cerebral herniation.

Dense right internal jugular vein highly suspicious for thrombosis; right sigmoid and transverse sinuses are unremarkable for a noncontrast study.

Conclusion: Features suggestive of right internal jugular vein thrombosis. 

CT

CT Venogram

Comparison made to CT brain from earlier the same day. There is a filling defect in the right internal jugular vein extending from the jugular bulb 2cm inferiorly. This is consistent with thrombus. No extension above the jugular foramen. The right sigmoid and transverse sinuses opacify normally. No other filling defect identified. Right trans labyrinthine craniotomy with fat packing. Pneumocephalus has resolved. No intracranial haemorrhage. Grey-white matter differentiation is preserved. Ventricular size is unchanged.

Courtesy of Dr Heather Pascoe

Case Discussion

This case illustrates a post-operative internal jugular vein thrombosis on the first day after excision of a right acoustic neuroma. 

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Case information

rID: 47936
Case created: 9th Sep 2016
Last edited: 13th Sep 2016
Tag: rmh
Inclusion in quiz mode: Included

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