CTV Neck
Claim CME CreditPOINT OF CARE INFORMATION
This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CA0586-CTV Neck
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CA0586-CTV Neck
Case ReportExam
Prior Study
There is evidence of aggressive right otomastoiditis with sigmoid plate dehiscence (coalescent otomastoiditis) producing a small volume, epidural abscess, which partiall compresses the adjacent dural sinus.
Focal deformity of the sigmoid sinus is evident at the site of epidural abscess, however, the remaining lumen of the right sigmoid sinus and the internal jugular vein are patent.
Intraluminal thrombus is present in the torcular herophile, the left transverse/sigmoid sinuses, extending into the high cervical left IJ.
CT Perfusion
No CT perfusion is available
Findings
CTV-MRV Neck
The cervical portions of the right internal jugular vein are patent. There is nonfilling of the left sigmoid/high cervical internal jugular vein junction, but detail is lost in bone density of the skull base. However,there is evidence of increased blood flow in the other left high cervical veins (evidence of collateral venous drainage), which provides secondary evidence of left high cervical IJ occlusion. The mid and lower cervical segments of the left IJ are patent.
Soft tissues of the neck and both the carotid and vertebral arteries are normal.
The CTA of the head was obtained at the time of the CTA evaluation of the neck. However, the head CTA imaged only the arterial phase. The arteries in the head were normal. However, there was no venous filling obtained. This was the outside hospital evaluation, and it is not uncommon to obtain CTA of the head and neck for acute neurological changes, expecting an arterial stroke. When this is normal then CNS venography imaging was obtained as in this case.
Impression
2. No soft tissue abnormality is evident within the cervical soft tissues.
3. The arterial phase head CTA was normal; no venous opacification was obtained, as expected.
