Department of Neurology, Chiba Rosai Hospital, Japan.
Department of Neurology, Graduate School of Medicine, Chiba University, Japan.
Intern Med. 2023 Jul 15;62(14):2129-2131. doi: 10.2169/internalmedicine.0764-22. Epub 2022 Nov 30.
The early diagnosis of cerebral venous thrombosis in the emergency department is challenging. A 70-year-old man presented to the emergency department after falling with new-onset convulsions. Brain unenhanced computed tomography (CT) revealed right frontal hemorrhage indicative of traumatic subarachnoid hemorrhage (SAH). Brain unenhanced CT on day 2 revealed increased density in the anterior superior sagittal sinus (SSS), namely 'dense inverted triangle sign.' Brain magnetic resonance venography showed a filling defect in the anterior SSS. When interpreting unenhanced brain CT findings in the setting of acute convulsions or cortical stroke, including SAH, cerebral sinus abnormalities near stroke foci should be evaluated carefully.
急诊科脑静脉血栓形成的早期诊断具有挑战性。一位 70 岁男性因突发抽搐而到急诊科就诊。头部未增强 CT 显示右侧额部出血,提示创伤性蛛网膜下腔出血(SAH)。第 2 天的头部未增强 CT 显示前上矢状窦(SSS)密度增加,即“致密倒置三角形征”。脑磁共振静脉造影显示前 SSS 充盈缺损。在急性抽搐或皮质性卒中(包括 SAH)情况下,解读未增强脑 CT 结果时,应仔细评估卒中病灶附近脑静脉窦的异常。