MRV Head
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.
CA0597-MRV Head
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CA0597-MRV Head
Case ReportExam
Prior Study
Acute thrombus has progressed and is now evident in most of the superior sagittal sinus (SSS), the straight sinus, the torcular herophile, the right transverse sinus and the initial segment of the left transverse sinus.
The hydrocephalus seen on initial imaging has resolved.
NO CT perfusion imaging is available
NO neck imaging was available
Findings
MRV Head
There is nonopacification (thrombosis) of all segments of the SSS, the torcular herophile, the right transverse/sigmoid sinus/IJ, and the initial segment of the left transverse sinus. The left sigmoid and internal jugular vein are patent.
Despite thrombosis of the SSS lumen, there are patent bifrontal and bilateral parietal (veins of Trolard), which connect across the midline through the venous lacunae. These veins are enlarged and have reversed filling pattern; they obviously provide significant cerebral pial venous collateraliztion. The left vein of Trolard exits into the left lateral venous confluence/lateral segment transverse sinus. The right vein of Trolard appear to connect with right transverse sinus dural wall collaterals. Both sides ultimatelydrain into the lateral aspect of the left transverse sinus.
There is partial opacification of the cavernous sinus. There is opacification of the inferior petrosal sinuses arising from the posterior aspect of the cavernous sinuses (indicating patentcy), but this is not a dominant route for cerebral venous egress
There is partial opacification of the deep central veins without apparent thrombosis.
