Superior sagittal sinus thrombosis

Case contributed by Dr Yair Glick

Presentation

Seizures - rule out SOL.

Patient Data

Age: 16 years

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 devestating consequences for the patient.

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Case information

rID: 88968
Published: 25th Apr 2021
Last edited: 26th Apr 2021
Inclusion in quiz mode: Included
Institution: Laniado Hospital

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