Cashew nut sign

Last revised by Rohit Sharma on 8 Sep 2022

Citation, DOI, disclosures and article data

Citation:

Sharma R, Cashew nut sign. Reference article, Radiopaedia.org (Accessed on 27 Apr 2024) https://doi.org/10.53347/rID-152263

DOI:

https://doi.org/10.53347/rID-152263

Permalink:

https://radiopaedia.org/articles/152263

rID:

152263

Article created:

8 Sep 2022, Rohit Sharma ◉

Disclosures:

At the time the article was created Rohit Sharma had no financial relationships to ineligible companies to disclose.

View Rohit Sharma's current disclosures

Last revised:

8 Sep 2022, Rohit Sharma ◉

Disclosures:

At the time the article was last revised Rohit Sharma had no financial relationships to ineligible companies to disclose.

View Rohit Sharma's current disclosures

Revisions:

3 times, by 1 contributor - see full revision history and disclosures

Systems:

Central Nervous System

Sections:

Signs

The cashew nut sign is a radiological sign described in juxtacortical intracerebral hemorrhages due to cerebral venous thrombosis, typically on CT.

The sign describes a small (<20 mm), concave-shaped intracerebral hemorrhage in the juxtacortical white matter, often near the bottom of a cortical sulcus, which resembles a cashew nut ^1-3. Presence of juxtacortical intracerebral hemorrhages has been found to be very specific (98%) for intracerebral hemorrhage due to cerebral venous thrombosis, typically of the superior sagittal sinus, but not very sensitive (26%) ^1,2.

It is thought that this unique cashew nut shape and juxtacortical location of hemorrhage is due to involvement of arcuate segments of the subcortical veins, which run parallel to subcortical U-fibers ^2,3. These subcortical veins drain into cortical veins and then venous sinuses and thus are affected by cerebral venous thrombosis ^2,3.