26 February 2017
Intracranial Hypotension with Dural Sinus Thrombosis
Contrast enhanced T1 sequences showing large thrombi in the posterior parts of the superior sagittal sinus (SSS). However note that this young female patient in postpartum period is also presenting with classical signs of Intracranial Hypotension. There is general dura enhancement, swelling of hypophysis and slight sagging of the cerebellum.
Transversal SWI and T2 show thrombus in SSS and swelling of the cortical veins.
Sagittal and transversal FLAIR sequences show thrombus with higher signal that is obstructing (black ) flow-voids in SSS.
It is believed that Intracranial Hypotension (that is most often caused by CSF leakage) is the reason for slowing down the venous blood flow in the dural sinus. However note that Dural Sinus Thrombosis (DST) is a very seldom complication of Intracranial Hypotension (2%). Most often does DST manifest as Intracranial Hypertension (20-40%).
Check my previous cases:
CSF Leakage - Intracranial Hypotension
CSF Leakage Spine - MRI Protocol
Idiopathic Intracranial Hypertension