Venöz Sinüs Trombozu Tanısında MRG’de Gradient Eko Sekansının Önemi

Venöz sinüs trombozu nadir görülen bir hastalıktır. Hastalar başağrısı, kraniyal sinir tutulumu, fokal nörolojik defisit, epileptik atak ve bilinç bulanıklığı ile başvurabilir. Daha önce hiçbir sağlık problemi olmayan 32 yaşındaki erkek hasta başağrısı, sol tarafta belirgin iki taraflı kuvvet kaybı ve sol homonim hemianopsi kliniği ile acil servise başvurdu. Kranial MR görüntülemede, gradient eko T2* GRE sekans görüntülerde transvers sinüste, juguler vende ve parankim içi venöz yapılarda belirgin hipointensite gözlendi. GRE bulgularına göre hastada VST tanısı düşünüldü ve tanı kontrastsız TOF MR-venografi ile doğrulandı. Hasta önce heparin ile antikoagüle edildi, 2 gün içinde başağrısı azaldı, daha sonra tedaviye warfarin ile devam edildi. Bir hafta sonra başağrısı ve nörolojik defisit tamamen düzeldi. VST tanısında MRG’de GRE sekansı önemli bilgiler sağlayabilir

IMPORTANCE OF GRE ON THE DIAGNOSIS OF VENOUS SINUS THROMBOSIS

Cerebral venous sinus thrombosis VST is a rare condition. Patients with cerebral venous thrombosis CVT may present with headache, cranial nerve palsies, focal neurological deficits, seizure and decreased level of consciousness. A previously healthy 32-year-old man presented to the emergency room with headache, paralysis and homonymous hemianopsia. A cranial MRI study was obtained and gradient-echo T2 weighted image GRE findings demonstrated pathological hypointensities in the transvers sinus, juguler vein and venous structures inside the paranchyme. VST was diagnosed based on the findings of GRE sequence and diagnosis was confirmed on non-contrast TOF-MR venography. The patient was anticoagulated with heparin. Over the next 2 days, the severity of the headache decreased, warfarin therapy was initiated, and the heparin infusion was tapered. A week later, his headache and neurological deficits disappeared completely. The GRE sequence imaging may provide useful knowledge in patient with VST

Keywords:

GRE Venous sinus thrombosis, MRI,

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