Eleven patients with angiographically and/or pathologically verified cerebral sinovenous occlusions not directly caused by
trauma were studied by computed cranial tomography (CCT). Static
radionuclide brain scans and dynamic
radionuclide flow studies were also obtained in four patients; in two, findings diagnostic of
lateral sinus thrombosis were noted. These comprised a "negative on dynamic, hot on static" image, as well as a "hot on static with nonfilling on angiography." Computed cranial tomography findings included visualization of the thrombosed vein ("cord sign") or sinus ("empty triangle" or "delta sign"), multiple focal bilateral parasagittal
hemorrhages, intense tentorial enhancement, gyral enhancement indistinguishable from
infarct, solitary intracerebral
hematoma, small ventricles, and normal scan. Excluding the patients with underlying
meningioma, all three of whom survived, seven of the remaining eight patients expired during the acute phase of their illness, an 88% mortality. This group includes one patient who had normal CCT findings, albeit without contrast enhancement, who was diagnosed as
pseudotumor cerebri. The need for full neuroradiological evaluation, including angiography, is thus stressed if this highly fatal yet treatable condition is not to remain undiagnosed.