Case Notes
History
30 year old female who is one week post partum and presents with severe headache and some nonspecific change in vision.Exam
MR susceptibility (SWI) sequence
Prior Study
CT headThere is thrombosis of the right vein of Trolard. There is hemorrhagic conversion of the thrombosed vein of Trolard producing local mass effects.There are small volume subarachnoid blood products evident within vertex sulci bilaterally and in both the suprasellar and prepontine cisterns.
CT Perfusion: No imaging available
CTV/MRV of the neck: No imaging available
MRV of the head
There is mesial segmental occlusion of the right vein of Trolard. Focal displacement of cortical veins in the right parietal vertex is related to the parenchymal hematoma associated with the vein of Trolard thrombosis.
Anomolous, hypoplastic frontal SSS segmental hypoplasia is present as an anatomic variant.
Delayed post contrast CT of the venocapillary pool: No imaging available
T1-w sequence: No imaging available
MR diffusion
Focal right vertex hemorrhage obscurs any evidence of MR diffusion positivity to confirm venous stroke.
MR T2-w/flair
Subtle signal abnormality is evident within the thrombosed segment of the vein of Labbe'. Focal hematoma is evident adjacent to the right Trolard vein thrombosis. The hematoma plus the surrounding edema produces some local mass effect, but no appreciable brain herniation. There is a dilated collateral pial vein adjacent to the posterior and lateral margin of the hematoma, which is secondary evidence of CVT.