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Dural venous sinus thrombosis

Case contributed by Varun Babu
Diagnosis certain

Presentation

Witheld

Patient Data

Age: 45 years
Gender: Male

CT brain

ct

The left-hemispheric sulci are effaced suggestive of unilateral cerebral hemispheric edema and a hyperdense left transverse sinus is noted in keeping with dural venous thrombosis. 

CT cerebral venography

ct

CT venography confirms the presence of a filling defect in a distended left transverse sinus. 

Annotated image
  • Image 1: effaced left-hemispheric sulci suggestive of unilateral cerebral hemispheric edema
  • Image 2: non-contrast study shows a hyperdense left transverse sinus
  • Image 3: a filling defect in a distended left transverse sinus in CT venography
  • Image 4: non-contrast study shows a hyperdense left transverse sinus
  • Image 5: a filling defect in a distended left transverse sinus in CT venography

Case Discussion

This middle aged gentleman came with slurred speech and acute onset right sided weakness. Stroke was suspected clinically and he was subjected to a CT brain study.

The finding of left hemispheric edema, with a dense left transverse sinus described as the cord sign, despite the contralateral sinus being the dominant one raised the suspicion of a venous infarct.

The absence of a territorial arterial infarction prompted for a CT venography study which confirmed a filling defect in left transverse sinus suggestive of dural sinus thrombosis. 

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