Hemorrhagic Cerebral Venous Infarction in a Patient with Atrial Fibrillation:

Abstract

Venous sinus thrombosis is an uncommon cause of stroke. Magnetic resonance imaging and magnetic resonance venography are sensitive and specific non-invasive tools for the diagnosis. This is a report of patient who presented with atrial fibrillation and heart failure. The course of the disease was complicated by left-sided transverse sinus thrombosis leading to hemorrhagic stroke. There was normal looking transverse sinus upon contrast injection with gadolinium despite the lack of flow on magnetic resonance venography. It is postulate that this apparently normal transverse sinus appearance on post gadolinium T1-weighted imaging was a result of thrombus enhancement in the acute stage of the venous occlusion. This finding could mislead the diagnosis if it was read in isolation without the confirmation of the occlusion in magnetic resonance venography.