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Dural venous sinus thrombosis: an overview and case report

ABSTRACT:

Torcular herophili is the site of the confluence of superior sagittal sinus, tranverse sinus, straight sinus and occipital sinus [1]. Anatomy of torcular herophili is highly variable. Dilatation of torcular herophili is presented as an anechoic triangular structure, with venous flow communicated with other sinuses and cerebral veins.

Torcular herphili thrombosis is a rare cerebrovascular disorder[9, 11, 13, 15], and the prenatal diagnosis of this condition is difficult. This condition can be caused by the abnormalities that produce prothrombotic states, such as acute fetal distress, and congenital deficiency of anticoagulants such as antithrombin III, protein C, and protein S[8]. Prenatal ultrasound is the firs-line modality for diagnosing and monitoring thrombosis of the torcular herophili. In addition, color-Doppler ultrasound helps to differentiate this disorder from other cerebrovascular malformations such as vein of Galen aneurysmal dilatation[5] and identify the presence of collateral vessels and its relationship with other dural sinuses[6, 7]. As a complementary technique, MRI can provide additional information to rule out secondary cerebral damages and associated brain malformations. Prognosis of this disorder is highly variable, ranging from spontaneous resolution with a normal neurologic outcome to severe neurologic deficits and death.

We present 1 case of thrombosis of ectatic torcular herophili with serial sonographic and magnetic resonance imaging (MRI) examinations, along with review of literature of this condition. Besides, we have a routine follow-up of the new-born mental development until now.

Keywords: thrombosis, torcular herophili, ultrasound, magnetic resonance imaging (MRI).

Method: case-report, prospective study from July 2017 until now.