Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
Case Reports
Susceptibility-Weighted Magnetic Resonance Imaging Detects Impaired Cerebral Hemodynamics in the Superior Sagittal Sinus Thrombosis
—Case Report—
Masahito KAWABORISatoshi KURODAKohsuke KUDOSatoshi TERAEMakoto KANEDANaoki NAKAYAMAYoshinobu IWASAKI
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JOURNALS OPEN ACCESS

2009 Volume 49 Issue 6 Pages 248-251

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Abstract

An 11-year-old female receiving treatment for acute lymphoblastic leukemia presented with superior sagittal sinus (SSS) thrombosis. T1-weighted, T2-weighted, and fluid-attenuated inversion recovery magnetic resonance (MR) imaging, and MR venography showed that the SSS was totally occluded by thrombus. Susceptibility-weighted MR imaging showed hypointense thrombus in the SSS and markedly dilated cortical veins over the bilateral cerebral hemispheres. Two days later, her symptoms had slightly resolved. Iodine-123 N-isopropyl-p-iodoamphetamine single photon emission computed tomography showed marked decrease of cerebral blood flow in the bilateral frontal lobes, indicating that venous congestion had disturbed the cerebral hemodynamics. MR venography showed that the SSS was still mostly occluded, but susceptibility-weighted imaging showed that the dilation of the cortical veins was less marked, suggesting that collateral venous routes had gradually developed. The finding of dilated cortical veins had almost disappeared at 28 days after the onset. Susceptibility-weighted imaging can be used as a non-invasive method to monitor the severity of venous congestion caused by cerebral venous sinus thrombosis.

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