Pediatric Stroke: Clinical Findings and Radiological Approach
Figure 2
A 16-year-old female with progressively worsening headache, generalized seizures on the 4th day and coma on the 5th day. MRI exam was performed on the 5th day. MRI T2-weighted Turbo Spin Echo (a) and T2-weighted Fluid Attenuated Inversion Recovery images (b) show altered signal intensity involving bilaterally medial thalamus, lentiform nucleus, and caudate nucleus. Intraventricular bleeding is present and hemorrhagic infarct involving right frontoparietal junction (not shown) was also detected. Superior sagittal sinus and internal cerebral veins seem to have regular “flow void” signal (arrows), due to the dark signal of subacute thrombus. MRI T1-weighted images before (c) and after (d) administration of contrast agent better show occlusion of superior sagittal sinus, vein of Galen and internal cerebral veins (arrows). Visible advanced signs of venous stasis and the so-called “delta sign” (arrow) (d).
