Figure 9.

(a) MRA of the Head and Neck to evaluate for stroke without evidence of acute ischemic infarct. Axial T2 sequence demonstrated abnormal T2 signal within the left sigmoid sinus extending to the internal jugular vein (white arrow), concerning for slow flow versus thrombus. CT Venogram was recommended but not obtained. (b) Diffusion weighted imaging demonstrated restricted diffusion in the left sigmoid sinus extending to the internal jugular vein, increasing suspicion for thrombus. (c) CT Angiogram of the Head and Neck to evaluate for stroke 3 months after initial MRA. There is non-opacification of the left sigmoid sinus (white arrow) compared to the opacified right sigmoid sinus, consistent with dural venous thrombosis.