Computed Cranial Tomographic Findings in Cerebral Sinovenous Occlusion

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Abstract
Eleven patients with angiographically and/or pathologically verified cerebral sinovenous occlusions not directly caused by trauma were studied by computed cranial tomography (CCT). Static radionuclide brain scans and dynamic radionuclide flow studies were also obtained in 4 patients: in 2, findings diagnostic of lateral sinus thrombosis were noted. These comprised a negative on dynamic, hot on static image, and a hot on static with nonfilling on angiography. Computed cranial tomography findings included visualization of the thrombosed vein (cord sign) or sinus (empty triangle of .DELTA. sign), multiple focal bilateral parasagittal hemorrhages, intense tentorial enhancement, gyral enhancement indistinguishable from infarct, solitary intracerebral hematoma, small ventricles and normal scan. Excluding the patients with underlying meningioma, all 3 of whom survived, 7 of the remaining 8 patients expired during the acute phase of their illness, an 88% mortality. This group includes 1 patient who had normal CCT findings, albeit without contrast enhancement, who was diagnosed as pseudotumor cerebri. The need for full neuroradiological evaluation, including angiography, is thus stressed if this highly fatal yet treatable condition is not to remain undiagnosed.