Presentation
Seizures - rule out SOL.
Patient Data
Hyperdense superior sagittal sinus and tributaries on non-contrast CT (NCCT).
Post-contrast, there are filling defects in the exact same locations as the hyperdensities on the NCCT, clinching the diagnosis of superior sagittal sinus and cortical vein thrombosis.
Small area of left frontal parasagittal edema with hemorrhagic focus, probably representing a venous infarct with hemorrhagic transformation.
Hyperdense focus in each globus pallidus.
Case Discussion
In this case, the thrombi in the SSS and its tributaries are well visible on the non-contrast scan.
A clotting panel showed antithrombin deficiency.
Cerebral venous thrombosis must always be sought actively, even on non-contrast studies, as missing this diagnosis could potentially lead to devastating consequences for the patient.
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