Differentiation of transverse sinus thrombosis from congenitally atretic cerebral transverse sinus with CT.

Stroke; a Journal of Cerebral Circulation
Yolanda ChikRafael H Llinas

Abstract

Transverse sinus thrombosis can have nonspecific clinical and radiographic signs. We hypothesized that the novel "sigmoid notch sign" (on head CT) can help differentiate transverse sinus thrombosis from a congenitally atretic sinus among individuals with absent signal in 1 transverse sinus by MR venography. We retrospectively evaluated 53 subjects with a unilaterally absent transverse sinus signal on MR venography. Eleven had true transverse sinus thrombosis and 42 had an atretic transverse sinus. Reviewers were trained in the sigmoid notch sign: "positive" if 1 of the sigmoid notches was asymmetrically smaller than the other, consistent with a congenitally absent transverse sinus on that side. This sign was scored on CT scans by 2 blinded reviewers to determine if signal dropout was clot or atretic sinus. A consensus rating was reached when the reviewers disagreed. Characteristics of the sigmoid notch sign as a diagnostic test were compared with a gold standard of full chart review by an independent reviewer. Each reviewer had a sensitivity of 91% (detecting 10 of 11 clots based on a negative sigmoid notch sign) and specificity of 71% to 81%; consensus specificity increased to 86% (36 of 42 individuals with an atretic sinus ha...Continue Reading

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Citations

Nov 23, 2013·Current Neurology and Neuroscience Reports·Christian Weimar
Jul 21, 2016·Stroke; a Journal of Cerebral Circulation·Sharon DevasagayamTimothy Kleinig
May 16, 2020·Stroke and Vascular Neurology·Yuhua FanUNKNOWN Chinese Stroke Association Stroke Council CVST Guideline Writing Committee
Apr 14, 2020·Neuroradiology·Monique BoukobzaHugues Chabriat
Apr 16, 2021·Fortschritte der Neurologie-Psychiatrie·Christian Weimar

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