Susceptibility-weighted magnetic resonance imaging detects impaired cerebral hemodynamics in the superior sagittal sinus thrombosis--case report

Neurol Med Chir (Tokyo). 2009 Jun;49(6):248-51. doi: 10.2176/nmc.49.248.

Abstract

An 11-year-old female receiving treatment for acute lymphoblastic leukemia presented with superior sagittal sinus (SSS) thrombosis. T(1)-weighted, T(2)-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.

Publication types

  • Case Reports

MeSH terms

  • Brain Ischemia / diagnosis
  • Brain Ischemia / etiology
  • Brain Ischemia / physiopathology
  • Cerebral Veins / diagnostic imaging
  • Cerebral Veins / pathology
  • Cerebral Veins / physiopathology
  • Cerebrovascular Circulation / physiology*
  • Cerebrum / blood supply
  • Cerebrum / diagnostic imaging
  • Cerebrum / physiopathology
  • Child
  • Contrast Media
  • Disease Progression
  • Female
  • Frontal Lobe / blood supply
  • Frontal Lobe / diagnostic imaging
  • Frontal Lobe / physiopathology
  • Humans
  • Hyperemia / diagnosis
  • Hyperemia / etiology
  • Hyperemia / physiopathology
  • Intracranial Thrombosis / diagnosis*
  • Intracranial Thrombosis / etiology
  • Intracranial Thrombosis / physiopathology*
  • Iofetamine
  • Magnetic Resonance Imaging / methods*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Predictive Value of Tests
  • Radiography
  • Recovery of Function / physiology
  • Superior Sagittal Sinus / diagnostic imaging
  • Superior Sagittal Sinus / pathology*
  • Superior Sagittal Sinus / physiopathology*
  • Tomography, Emission-Computed, Single-Photon
  • Vasodilation / physiology

Substances

  • Contrast Media
  • Iofetamine