Type:
Educational Exhibit
Keywords:
Diagnostic procedure, MR, CT, Neuroradiology brain, Embolism / Thrombosis
Authors:
B. Alami, S. Bellakhdar, M. Jaffal, O. Addou, M. Maaroufi, M. Boubou, I. Kamaoui, N. Sqalli, S. Tizniti; Fes/MA
DOI:
10.1594/ecr2013/C-0787
Background
In this retrospective study we analyzed the clinical and the neuroimaging findings of patients with cerebral venous thrombosis collected at our hospital from January 2009 to December 2011.
The diagnosis of cerebral venous thrombosis was made by MR and CT parenchymal images or with various venographic techniques: unenhanced time-of-flight MR venography,
and contrast material– enhanced MR venography and CT venography.
I.
Pathophysiology:(Fig.
1)
Venous thrombosis is related to three factors commonly known as “Virchow’s triad” including:
- Hypercoagulability
- Hemodynamic changes (stasis,
turbulence)
- Endothelial injury/dysfunction
The mechanism for venous infarction is obstruction of venous drainage with increasing venous pressure in the affected region of brain..
Cerebral venous infarction is initiated by thrombus propagation into draining cortical veins,
causing significant extravasation of fluid into brain (vasogenic edema) and producing focal cerebral edema and hemorrhage.
The lesion volume is probably influenced by the development of collateral veins.
II.
Anatomy of cerebral venous and dural sinus:(Fig.
2)
* Superior sagittal sinus,
transverse,
straight and sigmoid sinuses.
* Vein of Labbe,
which drains the temporal lobe.
* Vein of Trolard,
which is the largest cortical vein that drains into the superior sagittal sinus.
- Deep veins:
* Internal cerebral and thalamostriate veins.
- Cavernous sinus
III.
Radioanatomy of cerebral venous and dural sinus(Fig.
3=> 8)