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Images in Neurology
September 2010

An Unusual Case of Chronic Dural Thrombosis

Author Affiliations

Author Affiliations: Institutes of Neurology (Drs Pilato, Profice, Della Marca, and Di Lazzaro) and Radiology (Drs Gaudino and Colosimo), Università Cattolica, Rome, Italy.

Arch Neurol. 2010;67(9):1148-1149. doi:10.1001/archneurol.2010.212

A 43-year-old man presented in the emergency department with intense headache, vomiting, transitory disorientation, and language impairment. He complained of chronic headache and he had history of Wegener granulomatosis with pulmonary involvement. The diagnosis of Wegener granulomatosis was made 5 years before from a biopsy specimen of a pulmonary mass. Computed tomographic scan was performed and showed a bilateral hemispheric edema and calcification along the meninges with no sign of hemorrhage (Figure, A). Magnetic resonance imaging performed to evaluate the cerebral sinus showed dural calcification, occlusion of the sagittal and rectus sinus, and ectasia of cortical veins (Figure, B and C) consistent with venous sinus thrombosis. Magnetic resonance imaging 3-dimensional maximum intensity projections (Figure, D and E) better revealed cortical vein abnormalities with pronounced ectasia, consistent with chronic sinus thrombosis.

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