Venous infarct and dural venous sinus thrombosis

Case contributed by Dr Henry Knipe

Presentation

Headache and vomiting. .

Patient Data

Age: 45
Gender: Female

Small haemorrhage in the posterior right temporal lobe. Filling defect within the right sigmoid sinus. 

There is a right posterior temporal lobe parenchymal haemorrhage and has surrounding oedema. It does not extend to the cortical surface.

There is an extensive but incomplete filling defect in the middle third of the superior sagittal sinus, marked irregularity and attenuation of the left transverse sinus and a filling defect extending into the sigmoid sinus towards the jugular bulb, a filling defect in the lateral aspect of the sigmoid sinus on the right.

 

CT

One week later

Right parietotemporal haemorrhage with surrounding oedema. Significant mass-effect with subfalcine herniation of 12 mm to the left, previously 11 mm. Right uncal herniation is also apparent. No cerebellar tonsil herniation. Stable intraventricular haemorrhage pooling in the left trigone.

Case Discussion

This case demonstrates a haemorrhagic venous infarct (presumably ischaemic with haemorrhagic transformation). The cause of the infarct with dural venous sinus thrombosis. Venous infarcts should be considered for haemorrhages which are atypical in location. 

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Case information

rID: 39146
Case created: 21st Aug 2015
Last edited: 20th Nov 2015
Inclusion in quiz mode: Included

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