Wednesday, October 3, 2012

Dural Sinus Thrombosis

Dural sinus thrombosis (DST) is a venous occlusion likely secondary to increased intracerebral venous pressure. The classic sign on NCECT is hyperdense thrombus in the occluded sinus. CECT may demonstrate the empty delta sign: a filling defect that represents the thrombus surrounding by dural enhancement and collateral venous circulation. The MRI findings in DST are discussed here.

The first two images above demonstrate hyperdensity in superior sagittal sinus and torcular herophili. A left temporal lobe intraparenchymal hemorrhage is also noted. CT venogram (third image) demonstrates abrupt cut off at the level of the mid sagittal sinus that continues posteriorly. 

Leach JL, Fortuna RB, Jones BV, et al. Imaging of cerebral venous thrombosis: current techniques, spectrum of findings, and diagnostic pitfalls. Radiographics 2006;26:S19-41.

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