Cerebral venous hemorrhagic infarction

Discussion:

Venous sinus thrombosis is usually identified on non contrast CT, which is the first imaging investigation given the common nonspecific clinical presentation. It is challenging when not associated with venous hemorrhage or infarction as you must rely on the identification of an hyperdensity sinus, which could be trick sometimes. Things are easier in cases like the present one, where a typical venous hemorrhagic and infarction is present. 

As a result of the arterial supply to the infarcted tissue not being compromised, hemorrhagic transformation is common, and is typically heterogenous and gyriform

With contrast administration, especially with a CT venogram, then a filling defect in a sinus is sought. Multiplayer reformatted CT venography has been reported with a sensitivity of 95% for this diagnosis. 

 

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