Pediatric Dural Venous Sinus Thrombosis

Etiology: risk factors – hypercoaguability, contraceptives, dehydration, collagen vascular disease, lumbar puncture
Imaging: cortical vein thrombosis – thrombus forms central to peripheral, deep dural sinus thrombosis gets bithalamic edema / hemorrhage
CT: cord sign – hyperdense cord on non-contrast CT along thrombosed dural sinus
MRI: T1 hyperintense thrombus in superior sagittal sinus with empty delta on contrast enhanced
DDX:
Complications in neonate: venous infarction within region of brain that drains into sinus, involves thalami in medullary vein / straight sinus and Vein of Galen thrombosis, involves cortex and subcortical white matter with sagittal sinus thrombosis, infarction characteristically bilateral and hemorrhagic typically involving the cortex and subcortical white matter
Treatment:
Clinical:

Radiology Cases of Dural Venous Sinus Thrombosis

Radiology Cases of Dural Venous Sinus Thrombosis of the Sigmoid Sinus

CT of mastoiditis with dural venous sinus thrombosis — Axial CT with contrast of the brain with bone windows (left) shows complete opacification of the mastoid air cells bilaterally. MRV with contrast of the brain (right) shows a lack of venous flow in the right sigmoid sinus.

Radiology Cases of Dural Venous Sinus Thrombosis of the Superior Sagittal Sinus

US CT MRI of superior sagittal sinus thrombosis / SSST — Coronal spectral (upper left) and color (upper right) doppler US of the superior sagittal sinus shows decreased flow within it. Axial CT without contrast of the brain (below left) shows increased density in the superior sagittal sinus. Sagittal T1 MRI without contrast of the brain (below right) shows focal areas of increased signal intensity in the superior sagittal sinus.