Clinical and imaging features of cerebral venosinus thrombosis

Objective: To investigate the clinical and imaging features of cerebral venosinus thrombosis (CVT). Methods: The clinical and CT/MR imaging features of 30 patients with CVT were analyzed retrospectively. Results: The clinical manifestation was complex and nonspecific with headache as the most common symptom. CT, MRI and MR venography (MRV) showed thrombosis of the superior sagittal sinus (22), transverse sinus (22), sigmoid sinus (18), straight sinus (5), torcula (5), inferior sagittal sinus (1), cavernous sinus (1), deep vein (1), and cortical veins (1). CT demonstrated abnormality in 25/28 patients with stripe and triangular high densities (16), brain edema (15), cerebral infarction and hemorrhage. MRI showed loss of flow void with thrombus of varying age in 29/30 cases. MRV showed filling defects, signal loss and collateral circulation on all 30 patients including one patient with falsely normal MRI. Conclusion: The clinical manifestations of CVT are not specific. CT, MRI and MRV are noninvasive and sensitive whereas MRI combined with MRV is most accurate for diagnosing CVT. (authors)