Skip to main content

Advertisement

SpringerLink
Log in

Multimodality imaging in cerebral venous thrombosis: a synopsis for emergency radiologist

  • Pictorial Essay
  • Published:
Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Cerebral venous thrombosis (CVT) is an uncommon but potentially fatal condition which presents with a wide range of symptoms. Some of these presenting features are vague thus contributing to the delay in diagnosis. A prompt diagnosis and initiation of appropriate therapy are therefore of paramount importance. In this pictorial, we have tried to illustrate the direct and indirect imaging features of CVT in detail on multiple imaging modalities, along with the potential pitfalls of imaging.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16
Fig. 17

Similar content being viewed by others

References

  1. Bousser MG, Ferro JM. Cerebral venous thrombosis: an update. The Lancet Neurology. 2007;6(2):162–70.

    Article  CAS  PubMed  Google Scholar 

  2. Price EB, Moss HE. Osborn’s Brain: Imaging, Pathology, and Anatomy.

  3. Poon CS, Chang JK, Swarnkar A, Johnson MH, Wasenko J. Radiologic diagnosis of cerebral venous thrombosis: pictorial review. Am J Roentgenol. 2007;189(6 Suppl):S64-75.

    Article  Google Scholar 

  4. Rezoagli E, Bonaventura A, Coutinho JM, Vecchié A, Gessi V, Re R, et al. Incidence rates and case-fatality rates of cerebral vein thrombosis: a population-based study. Stroke. 2021;52(11):3578–85.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Stam J. Cerebral venous and sinus thrombosis: incidence and causes. Adv Neurol. 2003;92:225–32.

    PubMed  Google Scholar 

  6. Ferro JM, Canhão P, Stam J, Bousser MG, Barinagarrementeria F. Prognosis of cerebral vein and dural sinus thrombosis. Stroke. 2004;35(3):664–70.

    Article  PubMed  Google Scholar 

  7. Stam J. Thrombosis of the cerebral veins and sinuses. N Engl J Med. 2005;352(17):1791–8.

    Article  CAS  PubMed  Google Scholar 

  8. Masuhr F, Mehraein S, Einhäupl K. Cerebral venous and sinus thrombosis. J Neurol. 2004;251(1):11–23.

    Article  CAS  PubMed  Google Scholar 

  9. Zimmerman RD, Ernst RJ. Neuroimaging of cerebral venous thrombosis. Neuroimaging Clin North Am. 1992;2:463–85.

    Google Scholar 

  10. Caso V, Agnelli G, Paciaroni M. Handbook on Cerebral Venous Thrombosis. Basel, Karger: Front Neurol Neurosci; 2008. p. 4–15.

    Google Scholar 

  11. Shroff M. Sinovenous thrombosis in children. Neuroimaging Clin. 2003;13(1):115–389.

    Article  Google Scholar 

  12. Vijay RK. The cord sign. Radiology. 2006;240(1):299–300.

    Article  PubMed  Google Scholar 

  13. Virapongse C, Cazenave C, Quisling R, Sarwar MO, Hunter S. The empty delta sign: frequency and significance in 76 cases of dural sinus thrombosis. Radiology. 1987;162(3):779–85.

    Article  CAS  PubMed  Google Scholar 

  14. Teasdale E. Cerebral venous thrombosis: making the most of imaging. J R Soc Med. 2000;93(5):234–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Bonatti M, Valletta R, Lombardo F, et al. Accuracy of unenhanced CT in the diagnosis of cerebral venous sinus thrombosis. Radiol Med (Torino). 2021;126(3):399–404.

    Article  PubMed  Google Scholar 

  16. Alsafi A, Lakhani A, Carlton Jones L, et al. Cerebral venous sinus thrombosis, a nonenhanced CT diagnosis? Radiol Res Pract. 2015;4:2015.

    Google Scholar 

  17. Provenzale JM, Barboriak DP, Ortel TL. Dural sinus thrombosis associated with activated protein C resistance: MR imaging findings and proband identification. AJR Am J Roentgenol. 1998;170(2):499–502.

    Article  CAS  PubMed  Google Scholar 

  18. Yoshikawa T, Abe O, Tsuchiya K, et al. diffusion weighted magnetic resonance imaging of dural sinus thrombosis. Neuroradiology. 2002;44:481–8.

    Article  CAS  PubMed  Google Scholar 

  19. Van Gijn J. Cerebral venous thrombosis: pathogenesis, presentation and prognosis. J R Soc Med. 2000;93(5):230–3.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Favrole P, Guichard J, Crassard I, Bousser MG, Chabriat H. Diffusion-weighted imaging of intravascular clots in cerebral venous thrombosis. Stroke. 2004;35:99–103.

    Article  PubMed  Google Scholar 

  21. Baumgartner RW, Studer A, Arnold M, Georgiadis D. Recanalisation of cerebral venous thrombosis. J Neurol Neurosurg Psychiatry. 2003;74:459–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Afifi K, Bellanger G, Buyck PJ, et al. Features of intracranial hemorrhage in cerebral venous thrombosis. J Neurol. 2020;267(11):3292–8.

    Article  CAS  PubMed  Google Scholar 

  23. Barboza MA, Mejías C, Colin-Luna J, Quiroz-Compean A, Arauz A. Intracranial venous collaterals in cerebral venous thrombosis: clinical and imaging impact. J Neurol Neurosurg Psychiatry. 2015;86(12):1314–8.

    Article  PubMed  Google Scholar 

  24. Moudrous W, Tijssen C. Juxtacortical haemorrhage in cerebral venous sinus thrombosis:‘The Cashew Nut Sign.’ Case Rep. 2015. https://doi.org/10.1136/bcr-2015-211978.

    Article  Google Scholar 

  25. Oppenheim C, Domigo V, Gauvrit JY, et al. Subarachnoid hemorrhage as the initial presentation of dural sinus thrombosis. Am J Neuroradiol. 2005;26(3):614–7.

    PubMed  PubMed Central  Google Scholar 

  26. deVeber G, Andrew M, Adams C, et al. Cerebral sinovenous thrombosis in children. N Engl J Med. 2001;345(6):417–23.

    Article  CAS  PubMed  Google Scholar 

  27. Meckel S, Reisinger C, Bremerich J, Damm D, Wolbers M, Engelter S, Scheffler K, Wetzel SG. Cerebral venous thrombosis: diagnostic accuracy of combined, dynamic and static, contrast-enhanced 4D MR venography. AJNR Am J Neuroradiol. 2010;31(3):527–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Rollins N, Ison C, Reyes T, Chia J. Cerebral MR venography in children: comparison of 2D time-of-flight and gadolinium-enhanced 3D gradient-echo techniques. Radiology. 2005;235(3):1011–7.

    Article  PubMed  Google Scholar 

  29. Majoie CB, van Straten M, Venema HW, den Heeten GJ. Multisection CT venography of the dural sinuses and cerebral veins by using matched mask bone elimination. AJNR Am J Neuroradiol. 2004;25(5):787–91.

    PubMed  PubMed Central  Google Scholar 

  30. Hinman JM, Provenzale JM. Hypointense thrombus on T2-weighted MR imaging: a potential pitfall in the diagnosis of dural sinus thrombosis. Eur J Radiol. 2002;41(2):147–52.

    Article  PubMed  Google Scholar 

  31. Kang JH, Yun TJ, Yoo RE, et al. Bright sinus appearance on arterial spin labeling MR imaging aids to identify cerebral venous thrombosis. Medicine. 2017;96(41):8244.

    Article  Google Scholar 

  32. Leach JL, Bulas RV, Ernst RJ, Cornelius RS. MR imaging of isolated cortical vein thrombosis: the hyperintense vein sign. J Neurovasc Dis. 1996;1:32–8.

    Google Scholar 

  33. Crombe D, Haven F, Gille M. Isolated deep cerebral venous thrombosis diagnosed on CT and MR imaging. A case study and literature review. JBR BTR. 2003;86(5):257–61.

    CAS  PubMed  Google Scholar 

  34. Herrmann KA, Sporer B, Yousry TA. Thrombosis of the internal cerebral vein associated with transient unilateral thalamic edema: a case report and review of the literature. AJNR Am J Neuroradiol. 2004;25(8):1351–5.

    PubMed  PubMed Central  Google Scholar 

  35. Alper F, Kantarci M, Dane S, Gumustekin K, Onbas O, Durur I. Importance of anatomical asymmetries of transverse sinuses: an MR venographic study. Cerebrovasc Dis. 2004;18(3):236–9.

    Article  PubMed  Google Scholar 

  36. Ayanzen RH, Bird CR, Keller PJ, McCully FJ, Theobald MR, Heiserman JE. Cerebral MR venography: normal anatomy and potential diagnostic pitfalls. AJNR Am J Neuroradiol. 2000;21(1):74–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  37. Gökçe E, Pınarbaşılı T, Acu B, Fırat MM, Erkorkmaz Ü. Torcular Herophili classification and evaluation of dural venous sinus variations using digital subtraction angiography and magnetic resonance venographies. Surg Radiol Anat. 2014;36(6):527–36.

    Article  PubMed  Google Scholar 

  38. Arjona A, Delgado F, Fernandez-Romero E. Intracranial hypertension secondary to giant arachnoid granulations. J Neurol Neurosurg Psychiatry. 2003;74(4):418.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, India

    Sayani Mahal, Taruna Yadav, Pawan Kumar Garg, Pushpinder Singh Khera & Sarbesh Tiwari

  2. Department of Neurology, All India Institute of Medical Sciences, Jodhpur, India

    Samhita Panda

Authors
  1. Sayani Mahal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Taruna Yadav
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Samhita Panda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Pawan Kumar Garg
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pushpinder Singh Khera
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sarbesh Tiwari
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Taruna Yadav.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mahal, S., Yadav, T., Panda, S. et al. Multimodality imaging in cerebral venous thrombosis: a synopsis for emergency radiologist. Jpn J Radiol 42, 437–449 (2024). https://doi.org/10.1007/s11604-023-01522-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11604-023-01522-y

Keywords

Search

Navigation