A 28 y/o woman with history of headache and neurologic deficit.

 

 

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Doctor's Information

Name : Morteza
Family : Sanei Taheri
Affiliation :Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree : Associate Professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Razmin Aslani

 

Case Section

Neuroradiology

 

Patient's Information

Gender : Female
Age : 28

 

Clinical Summary

A 28 y/o woman with history of headache and neurologic deficit.

 

Imaging Findings

In brain MRI and MRV (axial, coronal T2W and axial and coronal T1w with and without Gd) signal abnormality (high in T2w and low in T1w) are seen at left parietotemporal lobe (infarct) also absent of signal void in left transverse sinus in noncontrast images and absent of sinus enhancement in contrast images.in MRV we can see thrombosis in left transverse sinus.

 

Differential Diagnosis

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Final Diagnosis

venous infarct due to sinus thrombosis

 

Discussion (Related Text)

The occlusion of venous structures can lead to focal cerebral infarction associated with focal or nonfocal neurologic symptoms. In most cases, the cause of infarction is thrombosis of one or more veins or dural venous sinuses. Cerebral vein and dural sinus thrombosis are often associated with certain predisposing conditions such as dehydration, infection, polycythemia, and sickle cell disease. The presence of a hypercoagulable state also appears to be an important risk factor.(1) Intracranial venous thrombosis may also occur in the peripartum period and may be seen in nonpregnant women taking oral contraceptive medications.(2) Compared with the location and extent of strokes resulting from arterial occlusion, the location and extent of strokes due to venous occlusion are much more variable. Nonetheless, location and extent of ischemia reflect, to some degree, the location and extent of venous occlusion. For example, when venous occlusion is limited to a cortical vein, findings of infarction may be unilateral and limited in extent to the region of the occluded vein. When venous thrombosis is more extensive, such as when extensive thrombus is present within a major dural sinus structure (e.g., the superior sagittal sinus), the findings of brain ischemia may be bilateral and more extensive. Hemorrhage is frequently associated with venous infarction, although the precise reasons are not known. Furthermore, the hemorrhages at are seen in ischemia as a result of venous occlusion are commonly subcortical in location.(3)

 

References

1-John R.Haaga , CT and MRI of the whole body , fifth edition 2009 , page 211-214. 2-Lanska Dj, Kryscio RJ: Risk factors for peripartum and postpartum stroke and intracranial venous tJlrombosis. Stroke 31: 1274-1282, 2000. 3-Keiper MD, Ng SE, AtJas SW, Grossman Rl: Subcortical hemorrhage: Marker for radiographically occult cerebral vein mrombosis on cr. J Comput Assist Tomogr 19:527-531, 1995.

 

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