Superior sagittal sinus thrombosis

Case contributed by Dr Mohammad A. ElBeialy

Presentation

Post sector mastectomy and chemoradiotherapy for right breast carcinoma and on hormonal treatment. The patient presents with a severe headache since a week.

Patient Data

Age: 50 years
Gender: Female
  • the superior sagittal sinus (SSS) appears slightly distended with lost signal void, demonstrating isointense to mildly hyperintense T1 and hyperintense T2/FLAIR signal intensity. Complementary MRV confirmed SSS thrombosis
  • thrombosed cortical veins are seen at the high frontoparietal cortical sulci with linear bands of high T2 and DWI signal
  • widened bilateral posterior parietal extra-axial CSF spaces
  • no definite evidence of parenchymal metastatic deposits
  • SWI/GRE fairly excludes subarachnoid or parenchymal hemorrhages
Complementary MRV confirmed SSS venous thrombosis. Attenuated rest of the dural venous sinuses.    

Case Discussion

Acute to subacute thrombosis of superior sagittal sinus with bilateral high frontoparietal thrombosed cortical veins.

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