Extensive CEREBRAL VENOUS SINUS THROMBOSIS with COLLATERAL formation


NONCONTRAST CT BRAIN
MR VENOGRAM BRAIN

35-year old gentleman presented with episodes of headache for the past two weeks. There were no other significant past history.

CT brain showed features of 1. Right transverse sinus thrombosis (red arrow), 2. Internal cerebral veins thrombosis (thin yellow arrow), 3. Straight sinus thrombosis (orange arrow), 4. Superior sagittal sinus thrombosis (thick yellow arrow)

MR Venography showed features of extensive venous sinus thrombosis, with multiple collaterals. This was suggestive of chronic venous sinus thrombosis. Collaterals are appearing tortuous, and a possibility of dural arterio-venous fistula should be kept in mind. A cerebral angiogram may be needed.

He was started on low molecular weight heparin injection, with which he had a good response. Work up for the causes of venous thrombosis is awaited.

Published by Dr Sudhir Kumar MD (Medicine) DM (Neurology)

I am a doctor with 25 years experience. I have worked as a neurologist for about 20 years. Educating public and healthcare professionals is very dear to me. This is possible due to my interactions with thousands of patients and their caregivers. I salute the patients who suffer and it is our duty to minimise suffering by preventing diseases and ensuring prompt diagnosis and treatment of those already affected.

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