“SOMETHING OLD”, “SOMETHING NEW”: DIRECT RADIOLOGICAL SIGNS IN CEREBRAL VENOUS SINUS THROMBOSIS
Eugenia ROTA, M.D., Luciano ARENA, M.D., Roberto PASTORINO, M.D., Lucia TESTA, M.D., Irene PAPPALARDO, M.D., Nicola MORELLI^, M.D.
Cerebral Venous Sinus Thrombosis (CVST) is a potentially life-threatening cause of stroke in young adults and although mortality has decreased in the past few decades, it is still relevant (5-10%). Moroever, despite the advances in neuroimaging techniques, the diagnosis of CVST remains challenging. Interest has grown as to the diagnostic potential of Magnetic Resonance Imaging (MRI) for Cerebral Venous Thrombosis, where ”old” signs on brain Computed Tomography (CT), like the “dense triangle” (on unenhanced scans) are detectable only in about 50% of thrombosis cases in the superior sagittal sinus. Recently, the “double-track sign” on MRI axial Gadolinium-enhanced T1 weighted imaging has proven to be a highly specific and moderately sensitive direct sign to detect transverse sinus thrombosis. Herein we report a case where a “marriage” between the “old” and “new” direct radiological signs (respectively, the “dense triangle” sign on unenhanced CT scans and the “double-track sign” on MRI sequences) allowed for an early diagnosis of CSVT secondary to mastoiditis, prompting treatment, with a good clinical outcome.[Full Text Article]