CT ANGIOGRAM AND CT HEAD:
CLINICAL HISTORY: Basal ganglia hemorrhage, rule-out sinus thrombosis.
FINDINGS:
Low density changes with mass effect are seen bilaterally (right greater than left) involving the basal ganglia and thalami. The
left lentiform nucleus and caudate are spared. There is also evidence of
generalized cerebral swelling with decreased size of sulci and basal cisterns noted. Gray-white matter differentiation along the convexities is maintained.
CTA performed from arch to circle of Willis demonstrates normal arterial structures. Three vessel arch anatomy is present. The carotid arteries and vertebral arteries are widely patent. No significant narrowing is seen.
Incidental note is made of fetal origin of the right posterior cerebral artery. The posterior circulation is otherwise unremarkable. The carotid arteries, middle cerebral arteries and anterior cerebral arteries bilaterally are patent.
IMPRESSION:
1. Evidence of bilateral deep venous infarcts with hemorrhage on the right and associated hydrocephalus either due to congestion or compression of the third ventricle as well as evidence of cerebral edema.
2. Straight sinus thrombosis with likely extension into the left transverse sinus.
3. Possible focal thrombosis of the superior left internal jugular vein.