Abstract
The cerebral sinuses are large, valveless, incompletely septated venous structures that are triangular in cross section, with a plexus of adjacent venous channels that act as collateral pathways for drainage in the event of thrombosis (3). As yet, no universally accepted pathophysiologic explanation for the appearance of the empty delta sign exists. However, numerous hypotheses include (a) recanalization of the thrombus within the sinus, (b) organization of the clot, (c) blood-brain barrier breakdown, and (d) dilatation of collateral peridural and dural venous channels (1). Virapongse et al (1) believed that the likely explanation was enhancement of the rich dural venous collateral circulation described above, consisting primarily of lateral lacunae, vascular mesh (dural cavernous spaces), and meningeal venous tributaries. This enhancement would surround the thrombosed sinus, producing the central region of low attenuation. DISCUSSION
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