fig 2.

Patient 2, a 41-year-old woman with vomiting, headaches, right hemianopsia, and right sensorimotor deficit of sudden onset.

A, MR angiogram (coronal 2D time-of-flight method, maximum intensity pixel reconstruction, lateral view), obtained 4 days after the onset of neurologic symptoms, shows an occlusion of the deep venous system (internal cerebral veins, straight sinus, vein of Galen). The right transverse sinus was also occluded (not shown).

B, Initial MR imaging and CT were performed 4 days after the onset of neurologic symptoms. CT scan shows a left capsulothalamic hematoma surrounded by edema. Axial FLAIR (10002/148/2200 [TR/TE/TI]) and diffusion-weighted (4000/120 [TR/TE], b = 1000 s/mm²) images show central thalamic hypoisointensity surrounded by areas of hyperintensity. ADC values (0.59 10⁻³ mm²/s) measured in the hemorrhagic thalamic lesion are at the lower limit of the normal range (z score of −1.91) and increased at the periphery (1.3 10⁻³ mm²/s, z score = 2.8).

C, Three months later, right hemiparesis persists along with areas of hyperintensity on T1- and T2-weighted images, suggesting the presence of hemorrhagic sequelae.