Wednesday 21 September 2011

Cord sign in CVT

Cerebral venous thrombosis (CVT) has variable clinical presentations.
Seventy-five percent of the CVT occur in young women, between 20 and 40 years of age, with the superior sagittal sinus (SSS) being most frequently affected (62% of cases).
Such increased incidence can be explained by pregnancy, puberty and use of oral contraceptives.
The diagnosis can be achieved by means of CT (the most readily available), magnetic resonance imaging (MRI) (the method of choice)
In 20% of cases, CT scans are normal.
CVT findings can be classified in direct and indirect.
The cord sign is a direct sign of CVT.
A focal vasogenic edema, infarction and hemorrhage are indirect signs.

"Cord sign" is a focal increased density on CT or a serpigenous low signal intensity on MRI T2*GRE due to thrombotic material in a vessel. 

The closest differential for this kind focal hyperdensity in the region of cortical sulcus on CT is sentinel sub arachnoid bleed and needs to be ruled out with MRI. 

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