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Radiological findings in cerebral venous thrombosis presenting as subarachnoid hemorrhage: a series of 22 cases

  • Diagnostic Neuroradiology
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Abstract

Introduction

The main objectives of the present study are to assess the incidence of cerebral venous thrombosis (CVT) presenting as isolated subarachnoid hemorrhage (SAH) and to determine the occurrence of cortical venous thrombosis (CoVT).

Methods

Among 332 patients with CVT, investigated with the same CT and MR standardized protocol, 33 (10 %) presented with SAH, associated in 11 cases with hemorrhagic infarct or intracerebral hemorrhage. This study is based on 22 cases of CVT presenting as SAH in the absence of hemorrhagic brain lesion. Diagnosis of sinus thrombosis was established on T2* and magnetic resonance venography and that of CoVT on T2* sequence. Diagnostic of SAH was based on fluid-attenuated inversion recovery (FLAIR) sequence.

Results

CVT involved lateral sinus in 18 patients, superior sagittal sinus in 16, and straight sinus in 1. Cortical veins were involved in all patients, in continuity with dural sinus thrombosis when present. SAH was circumscribed to few sulci in all cases and mainly localized at the convexity (21 cases). CoVT implied different areas on the same side in four patients and was bilateral in seven. There was no perimesencephalic or basal cisterns hemorrhage. Cortical swelling was present in 12 cases, associated with localized edema. All patients except one had a favorable outcome.

Conclusion

This report shows that the incidence of CVT presenting as isolated SAH is evaluated to 6.4 % and that SAH is, in all cases, in the vicinity of CoVT and when dural thrombosis is present in continuity with it.

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Abbreviations

CVT:

Cerebral venous thrombosis

CoVT:

Cortical vein thrombosis

SAH:

Subarachnoid hemorrhage

SSS:

Superior sagittal sinus

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Ethical standards and patient consent

We declare that all human studies have been approved by the Ethics Committee of our Institution and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neuroradiology and Therapeutic Angiography, Assistance publique – University Hospitals Lariboisière-St-Louis-Fernand-Widal, APHP – Paris-Diderot University, France.2, rue Ambroise Paré, 75010, Paris, France

    Monique Boukobza

  2. Department of Neurology, Assistance publique – University Hospitals Lariboisière-St-Louis-Fernand-Widal, APHP – Paris-Diderot University Paris, France, Paris, France

    Isabelle Crassard, Marie-Germaine Bousser & Hugues Chabriat

  3. INSERM UMR 1161 and DHU NeuroVasc, Paris, France

    Hugues Chabriat

Authors
  1. Monique Boukobza
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  2. Isabelle Crassard
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  3. Marie-Germaine Bousser
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  4. Hugues Chabriat
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Corresponding author

Correspondence to Monique Boukobza.

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Boukobza, M., Crassard, I., Bousser, MG. et al. Radiological findings in cerebral venous thrombosis presenting as subarachnoid hemorrhage: a series of 22 cases. Neuroradiology 58, 11–16 (2016). https://doi.org/10.1007/s00234-015-1594-5

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  • DOI: https://doi.org/10.1007/s00234-015-1594-5

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