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Abstracts from the Association of British Neurologists Annual Meeting 2011
086 The utility of different imaging modalities in the acute evaluation of venous sinus thrombosis
  1. A Rossor,
  2. B Talbot,
  3. C D Good
  1. Hurstwood Park Neurosciences Centre, Brighton and Sussex University Hospitals NHS Trust, UK


Acute venous sinus thrombosis often enters into the differential diagnosis of acute thunderclap headache when sub arachnoid haemorrhage has been excluded. When the pretest probability of a sinus thrombosis is high, then multiple imaging modalities my required in the event of a negative scan. The appropriate course of action for scenarios when the pre test probability is moderate or low is less clear. To help answer this question, we performed a blinded review of all imaging modalities (CT, CTV, MR, MRV (contrast and non-contrast enhanced) in a series of 53 patients who underwent brain imaging where sinus thrombosis was mentioned on the request card. Seven out of 53 patients had a confirmed sinus thrombosis of which five underwent a plain CT, MR and non-contrast enhanced MR venogram. The sensitivity and specificity of a plain CT was 71% and 96%, for a plain MR brain it was 100% and 97% and for a non-contrast enhanced MRV it was 80% and 91%. There was no significant difference in the sensitivity or specificity for the three modalities. In summary, our data suggest that a plain MR brain scan is superior to a non-contrast enhanced MR venogram in evaluating acute venous sinus thrombosis.

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