Dural sinus thrombosis - empty delta sign

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Hematology patient. Headache. Missed anticoagulants.

Patient Data

Age: 20 years
Gender: Female

Hyperdense posterior superior sagittal sinus on the non contrast images.

The patient was immediately recalled from accident and emergency for a CT of the venous sinuses.

Large filling defect in the posterior superior sagittal sinus, corresponding with the hyperdense area on the non contrast images. The filling defect extends into the right transverse sinus.

Filling defect in the right internal jugular vein and sigmoid sinus.

No parenchymal hemorrhage or venous infarct.

Case Discussion

The delta (non-contrast study) and empty delta (contrast study) signs are exquisitely demonstrated on this CT study.

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