Computed Tomography Imaging in Cerebral Venous Sinus Thrombosis Patients in Krathumbaen Hospital.
Keywords:
Venous sinus thrombosis, CT brain, seizure, headache, intraparenchymal hemorrhageAbstract
Objective: The aim is to evaluate computed tomographic imaging findings in venous sinus thrombosis.
Methods: Consecutive venous sinus thrombosis patients undergoing computed tomography (CT) in Krathumbaen Hospital from February 2016 to February 2021 were retrospectively reviewed to evaluate imaging findings and location of the thrombus.
Results: A total of fifteen venous sinus thrombosis patients undergoing CT were included. About 80% of patients were female with the average age of 50 years. Signs and symptoms were non-specific such as headache (46.7%), seizure (26.7%) and alteration of consciousness (26.7%). The imaging findings in non-contrast enhanced CT (NCCT) brain showed hyperdense sinus or cortical vein (60%) and brain parenchymal abnormalities (40%), including cortical hemorrhage (20%), cortical edema (13.3%) and bilateral thalamic edema (6.7%). There were 6 cases (40%) showing negative result. Contrast-enhanced CT (CECT) brain and CT venography (CTV) showed filling defects in the venous sinuses in 93.3 % of patients. There were multiple locations of the thrombosis in 12 patients (80%). The most common location was superior sagittal sinus (66.7%) followed by transverse sinus (53.3 %) with all in the right side.
Conclusion: The diagnosis of cerebral venous sinus thrombosis should be considered in middle aged women with non-specific neurological signs and symptoms. Since NCCT brain can demonstrate false negative result, contrast-enhanced studies particularly CTV is preferable. Most of the cases showed filling defects in multiple locations with the most common in superior sagittal sinus.
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