The above series was collected on a G1P0 who is 14 weeks pregnant and comes in complaining of a headache...just as you suspected, she got an eye exam showing papilledema and will be on heparin for at least 3-6 months (treating it like any old DVT). However the key points are the images (HCT not necessary, but illustrative):- Top 2 images of non-contrasted HCT and T2 MRI reveal clots in both the cerebral sinuses and the deep veins (vein of Galen), as indicated by the black-centered arrows.
- The second set of two images demonstrates the T1 sagittal and T2 axial MRI images of acute thrombosis (T1 isointense and T2 hypointense suggesting deoxyhemoglobin is present).
- The third pair of images are found as you scroll to the R lateral sigmoid sinus to find a sausage-like occlusion, confirmed by the mean-intensity projections (mIPs) of the susceptibility-weighted imaging.
- And, because you told the Ob/Gyn to get an MRV, you are rewarded with the answer of extensive sinus system occlusion.
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