Abstract

This is a Case Report of Vein of Trolard and superior sagittal sinus thrombosis with hemorrhagic stroke, a known but rare entity. Dural sinus thrombosis [DST] related hemorrhagic strokes are well known though they are rarer when compared to arterial brain infarctions. When compared to thrombosis of dural sinuses like superior sagittal sinus, thrombosis of the other smaller cerebral veins cause an even rarer form of stroke, with an incidence of 5 per million people each year. The interpreting radiologist has to be aware of multiple findings of cerebral venous sinus thrombosis [CVST], which are described in this current Case Report using various modalities along with literature review. The current case report also reminds one to look at that which is not seen, e.g., the non-enhancing right cortical vein of Trolard in the CT Venogram of this patient, which aids in further confirming the diagnosis. The cortical veins can vary in their location and can be asymmetric when compared to the other side. However, in a setting of non-arterial distribution hemorrhages with unclear etiology, focused evaluation of nonenhanced and enhanced venous structures can be very helpful in timely diagnosis leading to prompt patient care and good outcome.

Keywords:Superior Sagittal Sinus Thrombosis; Dural Sinus Thrombosis [DST]; Cerebral Venous Sinus Thrombosis [CVST]; Thrombosis of Cortical Vein of Trolard; Hemorrhagic Venous Stroke; Empty Delta Sign; Dense Cord sign

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