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A 18 year-old woman presented with headaches followed by lethargy and coma. On examination, she had papilledema. To a painful stimulus, she withdrew the left side better than the right.
Axial gradient echo MRI scans. Note the dark signals with the lesions of both hemispheres. Gradient echo is a sensitive measure of detecting hemorrhage. Thus, these lesions are bilateral ischemic as well as hemorrhagic. This pattern is consistent venous infarctions from thrombosis of the superior sagittal sinus.
The Electronic Curriculum is copyrighted 1998, Case Western Reserve University School of Medicine.