Post contrast head CT
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.
CA0607-Post contrast head CT
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CA0607-Post contrast head CT
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
CTV of the head
There is evidence of partial recanalization of dural sinus thromboses, which include the parietal-occipital segments of the SSS, the torcular herophile, the initial segment of the transverse sinuses, and the straight sinus.
Multiple effective routes of collateral venous egress are present, as listed above. There is also some antegrade venous blood flow after partial recanalization.
Findings
Post contrast head CT (venocapillary pool analysis)
The delayed post contrast head CT demonstrates no reduction in parenchymal CT density within the venocapillary pool of either the cortex or centronuclear parenchymal to confirm sufficienct oligemia to produce a venous stroke.
The lumen of the superior sagittal sinus is patent until the parietal-occipital junction where the contrast resides in the dural sinus wall (collateralization). The same is true for the straight sinus and mesial segments of the transverse sinuses. The lumina reappear for the transverse and sigmoid sinuses after the lateral tentorial venous confluences.
There is dilatation of the vein of Galen and ICV's consistent with venous congestion associated with venous egress block in the straight sinus and beyond.
The remainder of the exam is within normal limits with no evidence of hemorrhagic conversion.
Impression
There is moderate venous congestion in the deep central venous system. The venous congestion accounts for the size effacement of the upper third ventricle.
There is no evidence of venous stroke nor hemorrhagic conversion.
