Friday 6 January 2012

Sup sag sinus partial thrombosis

A 35 yo male with history of vertex headache and giddiness brought to casualty accompanied with a CT film showing bilateral parietal cortical hemorrhages. 
MRI Brain (Axial T2, T2GRE, Sagittal T1) with 2 D TOF MR Venogram
Bilateral parietal cortical hemorrhages on T2*GRE.
Axial T2w images, part of superior sagittal sinus adjacent to the bleed show an intra luminal hyperintense filling defect. Rest of the sinus show normal T2 flow voids.
T2*GRE images, thrombosed para sagittal cortical veins show low signal intensity.
Sag T1 images, an isointense thrombus in sup sagittal sinus in the first bang mid line section and isointense thrombosed cortical veins seen end on in the region of parietal cortical sulci in slightly off mid line sections.
MR Venogram, a small focal notching is seen in superior sagittal sinus in the corresponding region, rest of the superior sagittal sinus show normal flow related signals.

Imaging wise diagnosis : Thrombosed parasagittal cortical veins with partial thrombosis of part of superior sagittal sinus, an associated bilateral parietal hemorrhagic venous infarcts.


Anonymous said...

I did not agree, the defect is a Pacchioni granulation and there are may be trombosed cortical veins

Dr Balaji Anvekar said...

"Isolated thrombosis of cortical veins on either side at same time with normal intervening sss" ??? sure ?