T1 sagittal pre gad MRA T2 axial

Diagnosis: Dural sinus thrombosis

Dural sinus thrombosis most commonly involves the superior sagittal sinus. The sigmoid, transverse, and cavernous sinuses may also be involved. The more common predisposing factors include pregnancy, dehydration, oral contraceptives, infection, and coagulopathy. Up to one-quarter of all cases of dural sinus thrombosis are idiopathic. Patients often present with vague symptoms including headache and confusion. Diagnosis is often delayed which may result in progression to venous infarction. On enhanced CT, a filling defect maybe present in the superior sagittal sinus known as the "delta" sign which consists of clot within the opacified sinus. Infarction with hemorrhage may also be identified. High signal on T1 and T2 weighted images in the involved sinuses is characteristic. However, slow flow in the dural sinuses may mimic dural sinus occlusion. The most reliable way to exclude dural sinus occlusion on MR is to obtain a slow-flow sensitive MRA sequence such as 2D phase contrast. Related Cases

Straight sinus thrombosis Dural sinus thrombosis