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Related Experiment Videos

Dural sinus thrombosis: frequency and imaging diagnosis.

M Yousuf Chaudhary1, Ibrar Ahmed, Bilqees Afzal

  • 1Department of Diagnostic Radiology, Al- Shifa International Hospital (SIH), Islamabad.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|June 22, 2006
PubMed
Summary

Dural sinus thrombosis (DST) occurs in 3.3% of patients with neurologic symptoms, a higher frequency than previously thought. Subtle imaging signs on CT and MR scans, like the delta sign, are key for diagnosis, with MR venography used for confirmation.

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Area of Science:

  • Neurology
  • Radiology
  • Vascular Imaging

Background:

  • Dural sinus thrombosis (DST) is a rare but serious condition affecting venous drainage of the brain.
  • Subtle imaging findings on conventional computed tomography (CT) and magnetic resonance (MR) imaging can be easily missed.
  • Accurate and timely diagnosis is crucial for effective management and prevention of neurological deficits.

Purpose of the Study:

  • To determine the incidence of DST in patients presenting with diverse neurological complaints.
  • To emphasize the diagnostic significance of subtle imaging findings indicative of DST.
  • To evaluate the utility of magnetic resonance venography (MRV) in confirming DST.

Main Methods:

  • An observational case series included 1676 consecutive patients undergoing cranial CT and MR imaging over a three-year period.

Related Experiment Videos

  • Imaging studies were reviewed in real-time for evidence of DST.
  • Magnetic resonance venography (MRV) was utilized for patients with inconclusive conventional imaging results.

    • Main Results:

    • A total of 55 patients (3.3% frequency) were diagnosed with DST.
    • The 'delta sign' and 'empty delta sign' were the most common CT and MR findings.
    • Brain parenchymal edema or hemorrhage prompted further evaluation with MRV, confirming DST in subtle cases.

    Conclusions:

    • The 3.3% frequency of DST in neurologically symptomatic patients is higher than clinically recognized.
    • Subtle imaging signs of DST on CT and MR can be masked or absent, necessitating careful image scrutiny.
    • Brain parenchymal abnormalities suggestive of venous compromise warrant further investigation with MRV for definitive DST diagnosis.