Venous cerebral infarct

Case contributed by Aneta Kecler-Pietrzyk
Diagnosis certain

Presentation

Presented with a viral-like illness including vomiting and fever) followed by sudden unresponsiveness. No past medical/surgical history.

Patient Data

Age: 9 years
Gender: Female
ct

Straight sinus, right transverse and internal cerebral veins hyperdensity consistent with acute venous thrombosis at those locations

Bilateral hypodensity of both thalami in keeping with thalamic venous infarction.

mri

Uniform FLAIR hyper intensity of  both thalami corresponding to low signal on T1 and restricted diffusion on DWI consistent with acute ischemia. 

MRV MIP reconstructed images demonstrating complete occlusion of right transverse sinus, straight sinus and bilateral inferior cerebral veins consistent with central cerebral venous thrombosis.

Case Discussion

Cerebral venous / dural thrombosis is not commonly seen cause of brain ischemia.  It is commonly associated with underlying prothrombotic condition or systemic illness. In this case, the patient had factor III deficiency (which was diagnosed subsequently) and dehydration due to viral infection. 

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