Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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January 12, 2009
Thrombosis, Straight Sinus and Deep Cerebral Veins
- Symptoms commonly include headache (54%), nausea/vomiting (30%), decreased mental status (27%), and loss of consciousness (23%).
- Deep venous thrombosis may cause bithalamic ischemia and vasogenic edema manifesting as low CT density and high T2 signal.
- Cytotoxic edema and blood brain barrier breakdown may be seen as decreased diffusion and enhancement, respectively, in thalami, and these manifestations may less commonly extend to basal ganglia.
- Clot in affected veins appears dense on non-contrast CT, has high T1 signal, and may appear as a filling defect on contrast enhanced CT, MR, or MRV.
- Differential diagnosis for bithalamic lesions: glioma, lymphoma, and basilar artery distribution infarct in addition to venous thrombosis.
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