Diagnosis: Straight and left transverse sinus thrombosis with venous infarctions.
Dural sinus and central venous thrombosis may be due to dehydration and less likely meningitis in a neonate. Venus infarction is a complication of central venous or dural sinus thrombosis and may be seen in the temporal lobe if the transverse sinus, sigmoid sinus or vein of Labbe is occluded. Straight sinus thrombosis typically produces thalamic infarcts, while superior sagittal sinus thrombosis produces parasagittal infarcts. Up to 1/4 of venous infarctions are hemorrhagic. The combination of CT, MR, and MRA findings in this case is diagnostic of venous thrombosis with multiple hemorrhagic venous infarctions, the most prominent of which is in the right thalamus. The MR and MRA confirm that there is no flow in either the straight sinus or the left transverse sinus with reconstitution of the left sigmoid sinus probably via cortical venous drainage including the vein of Labbe. The bright signal seen in the superior sagittal sinus on the T1 sagittals is secondary to slow flow since the sinus is shown to be patent on the MRA sequence. Related Cases
