PMC4899810_01
75-year-old male with dural sinus thrombosis. Axial FSE T2 at the level of lateral ventricles shows diffuse hyperintensity signal of bilateral white matter of the frontal and parietal lobes. Some hyperintese areas near the middle cell and occipital horn of the left lateral ventricles are linked to vascular edema.
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The exam revealed diffuse signal alterations, hyperintense both on FSE T2-weighted (Figure 1, Figure 2) and FLAIR sequences (Fig. 3) in the subcortical and periventricular fronto-parietal white matter, associated with acute vascular lesions (mainly on the left side).
75-year-old male with dural sinus thrombosis. Axial FSE T2 shows diffuse signal hyperintensity of supraventricolar and subcortical white matter. These are associated with many small and medium hyperintense areas compatible with vascular infarctions.
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The exam revealed diffuse signal alterations, hyperintense both on FSE T2-weighted (Figure 1, Figure 2) and FLAIR sequences (Fig. 3) in the subcortical and periventricular fronto-parietal white matter, associated with acute vascular lesions (mainly on the left side).
75-year-old male with dural sinus thrombosis. Axial DWI (1000b) shows hyperintense areas, especially on the left frontal white matter, which are linked to acute vascular lesions.
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DWI (1000b) confirmed the recent onset of the vascular injuries (Fig. 4).
75-year-old male with dural sinus thrombosis. 3D-MIP (reformatted by 2D-TOF) sequence confirms venous flow reduction of the straight sinus near torcular of Herofilo (arrowheads); a flow reduction is also present at the level of the sagittal superior sinus, near the venous sinus confluence (arrows).
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The 2D-TOF sequence (TR, 29 ms; TE, 5.1 ms; thickness, 1.6 mm; gap, 0.8 mm) and the following three-dimensional reconstruction showed a reduced venous flow in the straight sinus near the torcular herophilii and in the superior sagittal sinus near the confluence of sinuses (Fig. 5). The flow reduction was compatible with partial cerebral venous thrombosis.
75-year-old male with dural sinus thrombosis. Axial SE T1 contrast enhancement shows multiple vessels with an oblique course between the wall of lateral ventricles and the subcortical white matter. Note particularly a vessel that surrounds the right frontal horn. A small enhancement area at the level of insular cortex represents minor telangiectasia.
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75-year-old male with dural sinus thrombosis. Axial FSE T2 obtained after 6 months shows a bilateral increase of fronto-parietal white matter signal alterations, with some chronic lacunar infarcts.
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T2-weighted sequences (Fig. 8) and decreased in the FLAIR sequence (Fig. 9). Those sequences also demonstrated the presence of many bilateral chronic residual lesions.
75-year-old male with dural sinus thrombosis. Axial DWI (1000b) obtained after 6 months shows the sequelae of vascular injuries (arrowhead).
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DWI (1000b) did not show brain parenchyma signal alterations (Fig. 10).
75-year-old male with dural sinus thrombosis. Coronal 2D-TOF slice obtained after 6 months shows the "threadlike" aspect of straight sinus with minimum residual flow (arrows).
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In the 2D-TOF sequence, the straight sinus maintained its "threadlike" aspect (Fig. 11); in the 3D-MIP reconstruction of this sequence, the superior sagittal sinus was minimally more visible than in the previous examination (Fig. 12).