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*It is only for medical professionals to read for reference.
Have you seen it? Everyone can read the imaging manifestations of cerebral infarction, but if you encounter cerebral infarction in these places within the skull, you must pay special attention.
Experienced diagnosis doctors will pay more attention to the details, otherwise the original disease will be missed
.
People don’t talk harshly.
First look at the video case: What can you think of when you see this case? It is estimated that novice diagnosticians only consider cerebral infarction.
.
.
and experienced diagnosticians will think of the underlying cause-cerebral venous infarction
.
The picture above shows Labbe venous drainage area infarction.
Plain scan (red arrow) shows high-density thrombus in the transverse sinus and bleeding in the infarct area.
Enhanced (blue arrow) shows the filling defect in the transverse sinus.
Is it difficult to diagnose cerebral venous infarction? The correct diagnosis can be made by grasping its typical distribution area, as shown in the figure below: Remembering these typical distribution areas is of great help to the diagnosis of cerebral venous infarction
.
Because imaging doctors or clinicians are not familiar with the distribution area of the disease, they will treat it as an infarction located in an atypical site or a non-arterial blood supply area
.
A brief description of cerebral venous thrombosis is atypical and easily missed
.
Common symptoms include: 90% of headaches, 40% of epilepsy, unexplained disturbance of consciousness, loss of consciousness, and papilledema
.
Venous thrombosis causes high venous pressure and causes vasogenic edema in the white matter of the affected area; when this process continues, it will cause infarction and cytotoxic edema; unlike arterial infarction, only cytotoxic edema, but not Angioedema
.
Due to high venous pressure, bleeding is more common in venous infarctions
.
Cerebral venous thrombosis is seen in order: large venous sinuses: superior sagittal sinus, transverse sinus, straight sinus and sigmoid sinus
.
Cortical veins: Labbe vein, temporal lobe draining vein; Trolard vein, the largest cortical vein draining to the superior sagittal sinus
.
Deep veins: intracerebral and thalamic striatal veins
.
Cavernous sinus
.
Source of this picture: Shenzhen Baoan MR Because many veins are located in the midline, venous infarction is often bilateral
.
Next, I will introduce three common venous thrombosis
.
1.
Superior sagittal sinus thrombosis The superior sagittal sinus is the most common blood vessel for venous thrombosis.
Once embolized, the chance of infarction can reach 75%
.
The image changes are more common in the parasagittal plane, and most of them are bilateral
.
Bleeding occurs in 60% of cases
.
Parasagittal edema and subacute hemorrhage sagittal reconstruction image shows bilateral parasagittal hemorrhage caused by superior sagittal sinus thrombosis, enhanced (red arrow) visible filling defect caused by thrombus 2.
Labbe vein thrombosis Labbe vein Thrombosis can also manifest as a typical venous infarction
.
As shown in the figure below
.
The white matter of the left temporal lobe and relatively less low-density shadows in the gray matter area, the slightly high-density shadows in the infarct area are bleeding, and the subtle high-density shadows (red arrows) in the left transverse sinus are the key to diagnosis.
Variations [angiogenic edema (red arrow), cytotoxic edema and hemorrhage (blue arrow)] and the site of disease (temporal lobe) should think of venous infarction caused by Labbe venous thrombosis, and CT or MRI enhancement is required in the next step Confirmed
.
3.
Flair sequence of deep cerebral venous thrombosis shows high signal shadow in the left thalamus and right basal ganglia.
Bilateral abnormalities need to consider the possibility of deep cerebral venous thrombosis.
CT-enhanced sagittal view shows the filling defect of the rectilinear sinus and the great cerebral vein (Blue Arrow) Summary: After reading this article, what will everyone think? The difference between a novice and a veteran in diagnosis is-seeing a kind of image performance, the novice's thinking will only stay in the appearance, while the veteran will think about the internal cause, which is the importance of experience
.
References: [1] Radiology Assistant: Barbara Simons, Geert Lycklama a Nijeholt and Robin Smithuis, Cerebral Venous Thrombosis.
Source of this article: Medical Imaging Service Center Editor in Charge: Mr.
Lu Li The published content is accurate and reliable at the time of review, but it does not make any promises or guarantees on the timeliness of the published content, as well as the accuracy and completeness of the cited information (if any), and does not assume that the content is out of date.
, Any liability arising from the possible inaccuracy or incompleteness of the cited information
.
Relevant parties are requested to check separately when adopting or using this as a basis for decision-making
.
For submission/reprint/business cooperation, please contact: yxjsjbx@yxj.
org.
cn
Have you seen it? Everyone can read the imaging manifestations of cerebral infarction, but if you encounter cerebral infarction in these places within the skull, you must pay special attention.
Experienced diagnosis doctors will pay more attention to the details, otherwise the original disease will be missed
.
People don’t talk harshly.
First look at the video case: What can you think of when you see this case? It is estimated that novice diagnosticians only consider cerebral infarction.
.
.
and experienced diagnosticians will think of the underlying cause-cerebral venous infarction
.
The picture above shows Labbe venous drainage area infarction.
Plain scan (red arrow) shows high-density thrombus in the transverse sinus and bleeding in the infarct area.
Enhanced (blue arrow) shows the filling defect in the transverse sinus.
Is it difficult to diagnose cerebral venous infarction? The correct diagnosis can be made by grasping its typical distribution area, as shown in the figure below: Remembering these typical distribution areas is of great help to the diagnosis of cerebral venous infarction
.
Because imaging doctors or clinicians are not familiar with the distribution area of the disease, they will treat it as an infarction located in an atypical site or a non-arterial blood supply area
.
A brief description of cerebral venous thrombosis is atypical and easily missed
.
Common symptoms include: 90% of headaches, 40% of epilepsy, unexplained disturbance of consciousness, loss of consciousness, and papilledema
.
Venous thrombosis causes high venous pressure and causes vasogenic edema in the white matter of the affected area; when this process continues, it will cause infarction and cytotoxic edema; unlike arterial infarction, only cytotoxic edema, but not Angioedema
.
Due to high venous pressure, bleeding is more common in venous infarctions
.
Cerebral venous thrombosis is seen in order: large venous sinuses: superior sagittal sinus, transverse sinus, straight sinus and sigmoid sinus
.
Cortical veins: Labbe vein, temporal lobe draining vein; Trolard vein, the largest cortical vein draining to the superior sagittal sinus
.
Deep veins: intracerebral and thalamic striatal veins
.
Cavernous sinus
.
Source of this picture: Shenzhen Baoan MR Because many veins are located in the midline, venous infarction is often bilateral
.
Next, I will introduce three common venous thrombosis
.
1.
Superior sagittal sinus thrombosis The superior sagittal sinus is the most common blood vessel for venous thrombosis.
Once embolized, the chance of infarction can reach 75%
.
The image changes are more common in the parasagittal plane, and most of them are bilateral
.
Bleeding occurs in 60% of cases
.
Parasagittal edema and subacute hemorrhage sagittal reconstruction image shows bilateral parasagittal hemorrhage caused by superior sagittal sinus thrombosis, enhanced (red arrow) visible filling defect caused by thrombus 2.
Labbe vein thrombosis Labbe vein Thrombosis can also manifest as a typical venous infarction
.
As shown in the figure below
.
The white matter of the left temporal lobe and relatively less low-density shadows in the gray matter area, the slightly high-density shadows in the infarct area are bleeding, and the subtle high-density shadows (red arrows) in the left transverse sinus are the key to diagnosis.
Variations [angiogenic edema (red arrow), cytotoxic edema and hemorrhage (blue arrow)] and the site of disease (temporal lobe) should think of venous infarction caused by Labbe venous thrombosis, and CT or MRI enhancement is required in the next step Confirmed
.
3.
Flair sequence of deep cerebral venous thrombosis shows high signal shadow in the left thalamus and right basal ganglia.
Bilateral abnormalities need to consider the possibility of deep cerebral venous thrombosis.
CT-enhanced sagittal view shows the filling defect of the rectilinear sinus and the great cerebral vein (Blue Arrow) Summary: After reading this article, what will everyone think? The difference between a novice and a veteran in diagnosis is-seeing a kind of image performance, the novice's thinking will only stay in the appearance, while the veteran will think about the internal cause, which is the importance of experience
.
References: [1] Radiology Assistant: Barbara Simons, Geert Lycklama a Nijeholt and Robin Smithuis, Cerebral Venous Thrombosis.
Source of this article: Medical Imaging Service Center Editor in Charge: Mr.
Lu Li The published content is accurate and reliable at the time of review, but it does not make any promises or guarantees on the timeliness of the published content, as well as the accuracy and completeness of the cited information (if any), and does not assume that the content is out of date.
, Any liability arising from the possible inaccuracy or incompleteness of the cited information
.
Relevant parties are requested to check separately when adopting or using this as a basis for decision-making
.
For submission/reprint/business cooperation, please contact: yxjsjbx@yxj.
org.
cn
