Pediatric Dural Venous Sinus Thrombosis

  • Etiology: risk factors – hypercoaguability, contraceptives, dehydration, collagen vascular disease, lumbar puncture
  • 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
  • Imaging: cortical vein thrombosis – thrombus forms central to peripheral, deep dural sinus thrombosis gets bithalamic edema / hemorrhage

Radiology Cases of Dural Venous Sinus Thrombosis

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.
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.