Postdural Puncture Superior Sagittal Sinus Thrombosis in a Juvenile Case of Clinically Isolated Syndrome

Figure 1

The magnetic resonance imaging of the patient reveals a large hyperintense lesion on FLAIR (a) and T2 (d) in the posterior limb of the left-sided internal capsule, probably extending to the thalamus. The other supratentorial lesions are much smaller (in the right occipital (d) and left temporal white matter ((b) FLAIR)). In the initial imaging the blood flow in the sagittal sinus was free ((c) gadolinium (Gd) enhanced T1w). 8 days later the white matter lesions were unchanged ((d) T2w, arrowhead pointing out a small lesion behind the occipital horn of the right ventricle) and some lesions were still Gd enhancing ((e) double arrowhead, Gd enhanced T1w). But now a thrombosis of the superior sagittal sinus can be seen ((e), (f) arrowheads, Gd enhanced T1w).

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