Dural Sinus Thrombosis with Nonsymptomatic Persistent Falcine Sinus: A Case Report.

Area of Science:

• Neurology
• Radiology
• Vascular Anatomy

Background:

• Congenital venous anomalies can predispose individuals to cerebrovascular complications.
• Persistent fetal falcine sinus is a rare anatomical variation of cerebral venous drainage.

Observation:

• A 24-year-old woman presented with convulsive status epilepticus.
• Cerebral magnetic resonance venography revealed a persistent fetal falcine sinus and a hypoplastic posterior superior sagittal sinus with abnormal deep venous drainage.
• Sinus thrombosis was identified in the hypoplastic superior sagittal sinus.

Findings:

• Cerebral angiography demonstrated delayed venous return in the left parieto-occipital lobe, suggesting cerebral venous stasis.
• The patient received heparin and antiepileptic drugs, resulting in complete neurological recovery.

Implications:

• This case highlights the potential link between congenital venous anomalies, specifically persistent fetal falcine sinus and superior sagittal sinus hypoplasia, and the development of sinus thrombosis.
• Cerebral venous stasis secondary to thrombosis in a hypoplastic superior sagittal sinus may precipitate convulsive status epilepticus.
• The persistent falcine sinus may act as an alternative drainage pathway, but hypoplasia of the superior sagittal sinus remains a critical factor.