Transverse sinus thrombosis

Case contributed by Dr Paul Simkin

Presentation

1 day post trans-labyrinthine approach resection of left cerebellopontine angle meningioma.

Patient Data

Age: 65
Gender: Male
CT

Left translabyrinthine craniectomy with fat packing. The surgical bed is filled predominantly with low-density fluid, with a small amount of high-density material medially likely blood products. Further high-density along the left tentorium cerebelli is likely also blood product. A small amount of pneumocephalus is seen.

High density in the region of the left transverse sinus is suspicious for thrombosis. The differential is post-surgical blood. There is no evidence of acute ischaemia or intraparenchymal haemorrhage. No hydrocephalus.

Conclusion:

High density in the left transverse sinus may represent venous sinus thrombosis. Correlation with CT (or MR) venogram should be performed if there is clinical concern.

CT

Short segment thrombosis measuring 3 cm of the left transverse sinus is noted. The left superior extracranial portion of the jugular vein, left sigmoid sinus and left inferior petrosal sinus are also unopacified consistent with thrombosis. The remainder of the cerebral venous sinuses including the torcular herophili opacify normally.

Case Discussion

This incidental post-operative finding had resolved by the follow up MRI a year later, and was never symptomatic for the patient.

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Case information

rID: 30451
Case created: 11th Aug 2014
Last edited: 17th Dec 2015
Inclusion in quiz mode: Included

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