Short case...Cerebral sinus thrombosis with congestive encephalopathy

1. Short case publication... version 1.4 | Edited by professor Yasser Metwally | January 2008
Short case
Edited by
Professor Yasser Metwally
Professor of neurology
Ain Shams university school of medicine
Cairo, Egypt
Visit my web site at:
http://yassermetwally.com
A 40 years old female patient presented with headache, fits, and disturbed level of
consciousness..
DIAGNOSIS: VENOUS CONGESTIVE ENCEPHALOPATHY SECONDARY TO VENOUS SINUS THROMBOSIS

2. Figure 1. Cerebral congestive encephalopathy. MRI T1 postcontrast study showing dural sinus and cortical
venous dilations and enhancement due to widespread dural sinus & cerebral venous thrombosis. The enhanced
cortical and transcerebral veins are seen forming the hyperdense cord signs which are seen radiating to the
dilated and thrombosed dural sinuses. Also notice parenchymal subcortical hypointensities and patchy, irregular
and linear enhancement with mass effect which could be due to edema, infarction or ischemia, forming what is
called cerebral congestive encephalopathy.
Figure 2. Venous congestive encephalopathy due to venous hypertension secondary to venous thrombosis. MRI
T2 images showing subcortical white matter hyperintensities with mass effect, mixed with linear and patchy
hypointensity and signal void structures. Changes are due to edema, petechial hemorrhages and dilated veins.

3. Figure 3. Cerebral congestive encephalopathy. MRI T1 postcontrast study showing dural sinus and cortical
venous dilations and enhancement due to widespread dural sinus & cerebral venous thrombosis. The enhanced
cortical and transcerebral veins are seen forming the hyperdense cord signs which are seen radiating to the
dilated and thrombosed dural sinuses. Also notice parenchymal subcortical hypointensities and patchy, irregular
and linear enhancement with mass effect which could be due to edema, infarction or ischemia, forming what is
called cerebral congestive encephalopathy.
Figure 4. MRI T1 postcontrast study showing dural sinus and cortical venous dilations and enhancement due
to widespread dural sinus & cerebral venous thrombosis. The enhanced cortical and transcerebral veins are
seen forming the hyperdense cord signs which are seen radiating to the dilated and thrombosed dural sinuses.
Also notice parenchymal subcortical hypointensities and patchy, irregular and linear enhancement which
could be due to edema, infarction or ischemia, forming what is called cerebral congestive encephalopathy.

4. Figure 5. MRI T1 postcontrast study showing enhancement and dilation of the thrombosed superior
sagittal sinus with central hypointense filling defects which could be due to the intraluminal thrombi.
Dilated enhanced cortical veins are seen pouring in the thrombosed sinus, subcortical parenchymal
hypointensity could be due to edema or infarction
Addendum
A new version of this software is uploaded in my web site every week (every Saturday and remains available till
Friday.)
To download the current version follow the link quot;http://pdf.yassermetwally.com/short.pdfquot;.
You can download the long case version of this short case during the same week from: http://pdf.yassermetwally.com/case.pdf or
visit web site: http://pdf.yassermetwally.com
To download the software version of the publication (crow.exe) follow the link: http://neurology.yassermetwally.com/crow.zip
At the end of each year, all the publications are compiled on a single CD-ROM, please contact the author to know
more details.
Screen resolution is better set at 1024*768 pixel screen area for optimum display
References
1. Metwally, MYM: Textbook of neurimaging, A CD-ROM publication, (Metwally, MYM editor) WEB-CD agency
for electronic publishing, version 9.1a January 2008