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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.
Revised
05/04/06.
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School of Medicine.