Which MRI findings are characteristic of cerebral vein and venous sinus occlusions in the workup of acute stroke?

Updated: Dec 19, 2018
  • Author: Souvik Sen, MD, MPH, MS, FAHA; Chief Editor: Helmi L Lutsep, MD  more...
  • Print
Answer

Answer

Occlusion of cerebral veins and venous sinuses is usually caused by systemic conditions, such as pregnancy, collagen-vascular diseases, inflammatory bowel diseases, and hypercoagulable states, as well as by local conditions, such as infection, neoplasia, and trauma. Occlusion of the venous structure causes outflow obstruction and vascular congestion that results in parenchymal infarctions and hemorrhages.

Patients usually present in the late acute phase or in the subacute phase, which makes the diagnosis difficult, because diagnosis at these stages depends on imaging studies. MRI findings in these lesions include loss of venous flow void signal, absence of normal venous enhancement, and visualization of isointense to hyperintense signals within the venous channels on T1 and T2 images. These variable patterns of enhancement are due to mixed blood products, which are present in the lesion. These patterns are usually bilateral, do not respect arterial vascular territories, and have associated hemorrhage.

Three-dimensional phase-contrast magnetic resonance venography (MRV) is the preferred technique in the evaluation of venous thrombosis.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!