Thrombosis of the superior sagittal sinus with resultant parenchymal hemorrhage

Axial and coronal enhanced CT scans reveal parenchymal hemorrhage in the left frontal lobe. Also note the empty delta sign on the coronal scan, consistent with thrombosis of the superior sagittal sinus. The hemorrhage and accompanying vasogenic edema are well seen on the T2-weighted GRE scan, with the low signal intensity consistent with either deoxyhemoglobin or intracellular methemoglobin. There is nonvisualization of the anterior portion of the superior sagittal sinus, due to clot, on the phase contrast (PC) venogram. Also seen on this exam is a filling defect in the more posterior portion of the sinus, which is visualized as well on the post-contrast coronal T1-weighted scan, reflecting the clot within this portion of the sinus, which is still patent.

 

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Part of the on-line supplement to Neuroradiology – The Essentials with MR and CT (© 2015)