Intracranial Hypotension with Cortical Vein Thrombosis

Findings:

Symmetric linear enhancement extends over both cerebral convexities, cerebellum, and tentorium. The dural sinuses are distended. Abnormal signal and lack of enhancement is present within a dominant right parietal cortical vein, associated with gradient echo blooming. Superimposed small FLAIR hyperintense extraaxial fluid collections are present over both convexities.

Differential Diagnosis/Discussion:

The differential diagnosis of diffuse uniform dural enhancement includes Low CSF pressure, pachymeningitis, and dural metastases. The distended dural sinus system should raise the possibility of low CSF pressure, and also low CSF pressure is associated with venous thrombosis.

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