Presentation
Severe headache for 2 days. The patient has a history of migraines, but the current pain is much stronger than usual. Today also impaired consciousness.
Patient Data
In the axial slices, the internal cerebral vein on both sides and the great cerebral vein are very hyperdense. Thalamus is clearly hypodense on both sides.
The hyperdensities are also very noticeable in the sagittal slices
On CT venography, the posterior sagittal sinus is filiform and less contrasted. Thrombosis of the internal cerebral vein on both sides and the great cerebral vein can be seen.
The findings can best be seen in the sagittal reconstruction
Case Discussion
Infarction in an atypical location (in a non-arterial distribution) may indicate a venous thrombosis. In this case, the thalamic infarction is an indication of the thrombosis of the great vena cerebri.
In general, attention must be paid to hyperdensities of the intracranial vessels on non contrast CT images.
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