Venous sinus thrombosis

Case contributed by Derek Smith
Diagnosis certain

Presentation

Post-partum. Headaches. Blurred vision and diplopia. Papilledema on examination.

Patient Data

Age: 30 years
Gender: Female
ct

Extensive venous sinus thrombosis within the distal superior sagittal sinus, straight sinus, confluence of sinuses, left sigmoid sinus and left proximal internal jugular vein.

Right transverse and sigmoid sinus spared.

Remainder of non-contrast imaging shows no abnormalities - in particular no mass lesion, infarct, hemorrhage, extra-axial collection or ventricular changes.

Annotated image

Annotated CT venogram. Thrombus highlighted in red.

Comparison made to right sided venous system without filling defect in blue.

Case Discussion

This lady was admitted to neurology with headaches and visual changes.

She was six weeks post-partum when these developed.

The investigations showed extensive thombosis through the cerebral venous system and she was managed with warfarin (after discussion about risks during breastfeeding).

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