case_images: PMC10637572_01
case_images: (A) Coronal T1 with contrast shows thrombus in the superior sagittal sinus and in a cortical vein at the vertex (*). Note diffuse thickening and enhancement of the dura (blue arrows). (B) FLAIR image showing right parietal lobe hemorrhage (*)and edema (arrow)resulting from the venous infarct. (C) At first resentation. Sagittal T2-weighted MRI showed full pituitary gland enlargement(arrows). (D) Sagittal T2-weighted MRI revealed ventral C1-C2 CSF accumulation(arrows). (E) 3-Month follow-up.The pituitary gland has decreased in size(arrows). (F) 3-Month follow-up.Sagittal T2-weighted MRI of the spine showed a significant decrease in cerebrospinal fluid collection.
case_images: fneur-14-1256200-g001.jpg
case_images: PMC10637572_01_fneur-14-1256200-g001.jpg
case_images: fig1
case_images: A head magnetic resonance imaging (MRI) + diffusion weighted imaging (DWI) + magnetic resonance angiography (MRA) study showed enlargement of the pituitary gland, descent of the cerebellar tonsils and brainstem, and crowding of the posterior fossa (Figure 1C). MRI scan showed hemorrhagic foci in the right parietal lobe with surrounding edema (Figure 1B), filling defects of the superior sagittal sinus, cystic signal shadow under the right top cranial plate, and diffuse enhancement of the dura and pia mater (Figure 1A). Multiple filling defects at the top and back of the superior sagittal sinus (Figure 1A) were shown on a brain magnetic resonance venogram (MRV), suggesting suggesting venous sinus thrombosis venous sinus thrombosis. Further MRI study of the cervical and thoracic vertebrae showed CSF collection at the C1-C2 level (Figure 1D), suggesting a dural CSF leak. Three months later, the pituitary gland returned to normal (Figure 1E). The spinal CSF collection was significantly reduced (Figure 1F).