Vein of labbe thrombosis with venous hemorrhage
Neuroimaging :
CT scan shows hyperdense left vein of labbe with adjacent subcortical venous ischemia
MRI of same patient showing thrombosed vein of labbe and progression of parenchymal changes to venous hemorrhage with edema
Thrombosis of superior sagittal sinus with parenchymal and intraventricular hemorrhage
Neuroimaging: Non-contrast CT scan (first image-NCCT) shows hyperdense superior sagittal sinus. Contrast enhanced CT (second image-CECT) shows filling defect in the superior sagittal sinus (empty delta sign) with flame shaped subcortical venous hemorrhages
Left transverse/sigmoid sinus thrombosis
Neuroimaging: MRI T1 and T2 weighted images show asymmetrical signal changes- T1 shortening/hyperintensity & loss of flow void in T2, suggestive of thrombosis.
Left transverse and sigmoid sinus thrombosis
Neuroimaging: Non contrast MRVenogram of the same patient shows loss of flow signal in left transverse and sigmoid sinuses
Superior sagittal sinus thrombosis with subcortical haemorrhage
Neuroimaging: Susceptibility weighted imaging shows blooming in the left frontal cortical vein, suggestive of thrombosis; MR venogram shows loss of flow signal in the anterior and middle superior sagittal sinus; Post contrast images show filling defects
Partial DWI-FLAIR imaging mismatch in acute stroke involving strategic locations might indicate reversible ischemia enabling thrombolysis even in those patients presenting in the extended time windows- Check out the video to crack this concept in stroke diagnosis
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