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Venous thrombosis of the vein of Galen, straight sinus, and dominant left transverse venous dural sinus.

Knaus CMK - MedPix (2013)

View Article: MedPix Image - MedPix Case

Affiliation: Walter Reed National Military Medical Center

ABSTRACT

Diagnosis: Venous thrombosis of the vein of Galen, straight sinus, and dominant left transverse venous dural sinus.

History: 17 yo girl presents with left sided facial weakness and numbness and the worst headache of her life that is rated 10/10. The headache has been progressive for about 24 hours. She has a history of migraine, but the patient states that her current headache does not feel like her typical migraine headache.

Findings: The vein of Galen, straight sinus, and dominant left transverse venous dural sinus are particularly hyperattenuating, and apparently prominent in caliber. The superior sagittal sinus is notably less hyperattenuating and is normal in appearance. The right transverse dural venous sinus is hypoplastic. Gray/white matter discrimination is preserved. There is no evidence for infarction or intracranial hemorrhage. There are no brain masses or mass effect. There is no hydrocephalus. The skull is intact. The partially imaged aerated portions of the skull base are free of significant effusions.. Impression: The vein of Galen, straight sinus, and dominant left transverse venous dural sinus are all particularly hyperattenuating and apparently prominent in caliber, all very concerning for thrombosis.

Ddx: Venous sinus thrombosis Severe dehydration Polycythemia

Dxhow: MRV (MR venography)

Exam: She is obese and has a history of polycystic ovarian syndrome (PCOS) and currently on oral contraceptive pills (OCPs) for symptom control. Exam is significant for her degree of discomfort and for confirming facial numbness. The facial strength is intact bilaterally.

No MeSH data available.


3D reconstruction has been rotated so that we view this from the posterior aspect.  (Pts right is on the left of the image.)
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MPX2175_synpic59076: 3D reconstruction has been rotated so that we view this from the posterior aspect. (Pts right is on the left of the image.)


Venous thrombosis of the vein of Galen, straight sinus, and dominant left transverse venous dural sinus.

Knaus CMK - MedPix (2013)

3D reconstruction has been rotated so that we view this from the posterior aspect.  (Pts right is on the left of the image.)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2175&req=5

MPX2175_synpic59076: 3D reconstruction has been rotated so that we view this from the posterior aspect. (Pts right is on the left of the image.)

View Article: MedPix Image - MedPix Case

Affiliation: Walter Reed National Military Medical Center

ABSTRACT

Diagnosis: Venous thrombosis of the vein of Galen, straight sinus, and dominant left transverse venous dural sinus.

History: 17 yo girl presents with left sided facial weakness and numbness and the worst headache of her life that is rated 10/10. The headache has been progressive for about 24 hours. She has a history of migraine, but the patient states that her current headache does not feel like her typical migraine headache.

Findings: The vein of Galen, straight sinus, and dominant left transverse venous dural sinus are particularly hyperattenuating, and apparently prominent in caliber. The superior sagittal sinus is notably less hyperattenuating and is normal in appearance. The right transverse dural venous sinus is hypoplastic. Gray/white matter discrimination is preserved. There is no evidence for infarction or intracranial hemorrhage. There are no brain masses or mass effect. There is no hydrocephalus. The skull is intact. The partially imaged aerated portions of the skull base are free of significant effusions.. Impression: The vein of Galen, straight sinus, and dominant left transverse venous dural sinus are all particularly hyperattenuating and apparently prominent in caliber, all very concerning for thrombosis.

Ddx: Venous sinus thrombosis Severe dehydration Polycythemia

Dxhow: MRV (MR venography)

Exam: She is obese and has a history of polycystic ovarian syndrome (PCOS) and currently on oral contraceptive pills (OCPs) for symptom control. Exam is significant for her degree of discomfort and for confirming facial numbness. The facial strength is intact bilaterally.

No MeSH data available.