Cerebral venous thrombosis-post-traumatic

Left frontal & temporal lobe hemorrhagic cerebral contusions. Transverse fracture of the right petrous temporal bone extending posteriorly into the right occipital bone associated with diastasis of the right occipitomastoid suture, fractured posterior wall of the sphenoid sinus & right clivus, fractured roof and medial wall of the right orbit associated with mild pneumocephalus, right hemo-mastoid & hemotympanum, hemo-sinuses, blood in the nasopharynx and posterior nasal cavities, high right parietal subgaleal hematoma, preseptal soft tissue thickening of the right orbit and a few small foreign bodies related to the conjunctiva of the right eye. No intraventricular hemorrhage, hydrocephalus, midline shift or brain herniation is seen.

Hyperdense right distal transverse sinus, right sigmoid sinus and right internal jugular vein at the level of base of skull; this finding was not seen on the baseline scan. Post contrast study shows some filling defects in these aforementioned sinuses as well as the right internal jugular vein at the level of base of skull. The remaining right internal jugular vein is patent and well-opacified. Left transverse and sigmoid sinuses as well as the left internal jugular vein are patent and well-opacified. The remaining cerebral venous sinuses are patent and well opacified. Hypoplastic A1 segment of the right anterior cerebral artery; otherwise, morphology of the branches of the circle of Willis is within normal limits.

Interval development of minimal subarachnoid hemorrhage (interpeduncular cistern) and small subdural hematoma in the right temporal region. Interval resolution of the pneumocephalus. Rest of the findings are same as seen on the previous study. Fractured medial end of the left clavicle and acromion process of the right scapula.

Selected images with annotation from the follow-up scan showing the thrombosed right distal transverse sinus, sigmoid sinus and right internal jugular vein (at base of the skull).