Absence of flow void in left transverse and left sigmoid sinus, Large area of altered signal intensity in left parieto-temporal lobe.

• Large area of altered signal intensity in left parieto-temporal lobe → indicates hemorrhagic venous infarct (a type of stroke caused by blocked venous drainage, leading to brain tissue damage and bleeding).

• Absence of flow void in left transverse and left sigmoid sinus + no signal on MR Venography (2D TOF) → indicates Cerebral Venous Sinus Thrombosis (CVST) — a blood clot in the brain’s venous sinuses.

Cause (Etiology)

Cerebral venous sinus thrombosis (CVST) can occur due to many reasons:

1. Hypercoagulable States (Increased Clotting Tendency):

• Dehydration (common in children or hot climates)

• Pregnancy or postpartum period

• Oral contraceptive pills (OCPs)

• Thrombophilia (inherited or acquired clotting disorders)

• Malignancy (cancer)

• Infections (especially ear, mastoid, or sinus infections)

2. Local Infections:

• Otitis media (middle ear infection)

• Mastoiditis

• Sinusitis

• Meningitis

3. Systemic Conditions:

• Head trauma or brain surgery

• Autoimmune diseases (e.g., lupus, vasculitis)

• Severe anemia or polycythemia

• COVID-19 infection or vaccination-related (rare)

 Symptoms

Symptoms depend on the size and site of thrombosis, but common signs include:

System/Area	Symptoms
Headache	Severe, persistent headache (most common symptom)
Neurological deficits	Weakness or paralysis (especially opposite side of the clot)
Seizures	Common due to venous infarct and hemorrhage
Visual symptoms	Blurred vision or double vision (due to raised intracranial pressure)
Altered sensorium	Confusion, drowsiness, or even coma in severe cases
Speech issues	If parieto-temporal lobe is involved (aphasia)
Vomiting/Nausea	Due to raised intracranial pressure

Precautions / Lifestyle Modifications

• Stay well-hydrated

• Avoid smoking or alcohol

• Avoid hormonal pills (unless medically necessary)

• Regular follow-up MRI/MRV to monitor recanalization

• Maintain healthy weight and diet rich in fruits/vegetables

• Regular medical checkup for blood coagulation profile if history of thrombosis