CTV 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.
CA0606-CTV Head
View Images
CA0606-CTV Head
Case ReportExam
Prior Study
Acute thrombosis is evident within the posterior (parietal/occipital) segments of the superior sagittal sinus extending into the torcular herophile and the straight sinus. There is no apparent cortical or deep central vein CVT
CT perfusion No CT perfusion is available
CTV of the neck NO CTV neck is available
Findings
CTV-MRV Head
There is evidence of distal sagittal sinus, torcular herophile, straight sinus, and mesial segment transverse sinus thromboses. The lateral transverse sinuses are both opacified at the level of the lateral tentorial venous confluences, where re-routed pial venous drainage is directed. There is some contrast in the dural wall of the distal SSS, the straight sinus, and both mesial transverse sinuses indicating dural wall collateralization; the lumen of these affected sinuses are not opacified.
There is re-routing of the cerebral pial venous egress bilaterally. There is physiologic enlargement of the frontal, parietal, and superior sylvian cortical veins with reversed filling into the vein of Labbe'/lateral tentorial confluences. There is also re-routing into the superior sylvian vein/sphenoparietal sinus pathway. There is prominent venous filling in the pharyngeal venous plexes consistent with re-routing through the cavernous sinus. There is dilation of the deep central veins consistent with mild to moderate venous congestion, but there is no deep central venous thrombosis. The deep central venous system is collateralized mainly through both the lateral mesencephalic (LAM)/petrosal venous and superior vermian collateral pathways.
The sigmoid sinuses and the internal jugular veins are patent.
There are enlarged extracranial veins on the left in the lateral occipital area. These imply the presence of patent emissary vein collaterals for the left transverse sinus thrombosis.
Impression
Multiple effective routes of collateral venous egress are present for both the cortical pial veins. There is fair collateral formation for the deep central venous system, but the central veins are dilated consistent with mild to moderate venous congestion.
