Imaging Contribution in Headache and Cerebral Venous Thrombosis (CVT)

Abstract

Headache is the most frequent and the mean onset symptom in cerebral venous thrombosis (CVT). Recognizing CVT to start treatment early enough is a challenge for both the clinician and the radiologist. They must find the right balance between not to expose the patient to the unnecessary risks of anticoagulants and not to miss a condition that could be fatal. CVT has a wide variety of clinical manifestations that often causes of a delay in diagnosis. Neuroimaging techniques have significantly improved to explore the brain parenchyma and its vascular structures. High-field MRI is the current gold standard because of its high tissue resolution and its multiform contrast without equality. But its limits lie on the accessibility and availability, especially in our developing countries. CT is more accessible and available. Its fast running and current performance because of multidetector technology make it the firstline examination and the only one in many cases of neuroradiology emergency. These techniques present sometimes some trap pictures that must be recognized not to carry the diagnosis by excess or to miss it. We aim in this article to review the semiology of headaches in CVT, some risk factors, CT semiology, and some CT trap pictures.