Presentation
Decreased GCS
Patient Data
The most important yet subtle abnormality is the presence of hyperdense left transverse, sigmoid and left internal jugular vein.
No acute bleeding or infraction at the time of the examination.
Extensive white matter ischemic changes are also noted.
Post-contrast examination confirms the non-enhancement of the above-mentioned veins confirming the venous sinus thrombosis. This is a critical finding.
Case Discussion
Venous sinus thrombosis is a critical imaging finding, once found, search for the following:
complications: The presence of hemorrhagic venous infarction (sometimes can be quite subtle), and any associated complication as mass effect and brain herniation
underlying cause: as nearby infection (e.g mastoiditis) or infiltrating tumor or patient hypercoagulable status
evaluate the extension and if it involves the deep venous system of the brain
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