PMC8053462_01
Case 1, noncontrast computed tomography (CT) brain. (a) preoperative CT showed right frontal intracerebral hemorrhage with compression of ipsilateral frontal horn and midline shift. (b) postoperative CT brain. Decompression of the mass effect exerted by the hematoma with pneumocephalus in the bed of surgical site.
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F1
CT brain, magnetic resonance imaging (MRI), and magnetic resonance venography (MRV). CT findings were of right frontal intracerebral hemorrhage with midline shift [Figure 1a].
Case 1, (a) T1 WI with contrast showed right frontal intracerebral hemorrhage with surrounding edema, obliteration of ipsilateral frontal horn and displacement of contralateral horn with midline shift. (b) FLAIR image. The marked hypointensity of the ICH is most likely caused by the T2 shortening effects of intracellular methaemoglobin present abundantly in the clot at this stage.
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F2
MRI and MRV showed an evidence of superior sagittal sinus occlusion with hemorrhagic transformation of venous infarction [Figures 2-4].
Case 1 preoperative coronal T1WI with contrast (a) and T2 WI (b).
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F3
MRI and MRV showed an evidence of superior sagittal sinus occlusion with hemorrhagic transformation of venous infarction [Figures 2-4].
Case 1 preoperative magnetic resonance venography. Note occlusion of anterior half of SSS as well as left transverse sinus and sigmoid sinus.
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F4
MRI and MRV showed an evidence of superior sagittal sinus occlusion with hemorrhagic transformation of venous infarction [Figures 2-4].
Case 1 (a) Postoperative T1 WI without contrast, note disappearance of mass effect and replaced by encephalomalacic area filled with CSF appears as hypointense signal on T1 and hyperintense on T2 in (b) image. (c) T1 WI with contrast, note the slight enhancement of neural tissue and fill-defect in the superior sagittal sinus.
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F5
MRI brain with/without contrast were done and revealed resolution of cortical and subcortical damage with small area of encephalomalacia, MRV showed obliteration of cortical veins and anterior half of superior sagittal sinus [Figures 5 and 6].
Case 1 postoperative magnetic resonance venography. Note occlusion of anterior 1/2 of the SSS as well as cortical veins on right side.
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F6
MRI brain with/without contrast were done and revealed resolution of cortical and subcortical damage with small area of encephalomalacia, MRV showed obliteration of cortical veins and anterior half of superior sagittal sinus [Figures 5 and 6].
PMC8053462_02
Case 2 noncontrast computed tomography scan showed right occipito-temporal hematoma with midline shift and slight extension to ventricle. Note hypodensity of the ipsilateral hemisphere.
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F7
CT scan was done and a large occipitoparietal hematoma was seen on right side [Figure 7], MRI obtained early before surgery showed signal void in the right transverse sinus [Figures 8 and 9].
Preoperative T2 WI. Note signal void of the right transverse sinus.
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F8
CT scan was done and a large occipitoparietal hematoma was seen on right side [Figure 7], MRI obtained early before surgery showed signal void in the right transverse sinus [Figures 8 and 9].
Case 2 magnetic resonance venography. Note stenosis of the right transverse-sigmoid sinus.
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F9
CT scan was done and a large occipitoparietal hematoma was seen on right side [Figure 7], MRI obtained early before surgery showed signal void in the right transverse sinus [Figures 8 and 9].
Case 2 (a) dural incision showed congested and marvellous edema with engorged cortical veins. (b) Blood clots retrieved from hematoma.
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F10
Cortical veins were extensively thrombosed intraoperatively [Figure 10a]. Blood clots were retained from within the infarcted brain [Figure 10b].