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Cerebral venous infarction

Case contributed by G Balachandran
Diagnosis almost certain

Presentation

Referred for evaluation of acute confusional state.

Patient Data

Age: 40 years
Gender: Male
mri

Focal T1 and T2 hyperintense at the left temporal lobe with restricted diffusion demonstrated on DWI corresponds to an area of subacute hemorrhagic infarct. Subtle thin T2 hypointense rim is in keeping with hemosiderin deposition.
MR venography further demonstrates absence flow of the distal superior sagittal, left transverse and left sigmoid sinuses.

Case Discussion

Features are in keeping with extensive cerebral sinus thrombosis involving the distal superior sagittal, left transverse and left sigmoid sinuses, resulting in venous hemorrhagic infarct of the left temporal lobe.

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