title: Whole-Brain Computed Tomographic Perfusion Imaging in Acute Cerebral Venous Sinus Thrombosis.
abstract: BACKGROUND
  Acute cerebral venous sinus thrombosis (VST) can be difficult to diagnose because of its diverse clinical presentation. The utility of perfusion imaging for diagnosing VST is not well understood.
  
  
  CONCLUSIONS
  We retrospectively reviewed cases of acute VST in patients who underwent whole-brain (320-detector-row) computed tomographic (CT) perfusion imaging in combination with craniocervical CT venography. Perfusion maps that were analyzed included cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time, and time to peak. Among the 10 patients with acute VST included in this study, 9 had perfusion abnormalities. All perfusion abnormalities were localized in areas adjacent to the occluded sinus and did not match typical anterior or posterior circulation arterial territories. Bilateral perfusion deficits were seen in 4 cases. In 2 cases, parenchymal hemorrhage was diagnosed on noncontrast CT imaging; in those cases, focal CBV and CBF were reduced.
  
  
  CONCLUSIONS
  Whole-brain CT perfusion imaging with 320-detector-row scanners can further assist in establishing the diagnosis of VST by detecting perfusion abnormalities corresponding to venous and not arterial territories. CT perfusion could assist in the differentiation between focal reversible changes, such as those caused by vasogenic edema, and irreversible changes due to infarction.
authors.affiliation: Departments of Neurosurgery, School of Medicine and Biomedical Sciences USA; Department of Neurosurgery, Gates Vascular Institute/Kaleida Health, Buffalo, N.Y., USA.
authors.forename: Maxim
authors.initials: M
authors.lastname: Mokin
authors.affiliation: Departments of Neurosurgery, School of Medicine and Biomedical Sciences USA; Department of Neurosurgery, Gates Vascular Institute/Kaleida Health, Buffalo, N.Y., USA.
authors.forename: Chelsey C
authors.initials: CC
authors.lastname: Ciambella
authors.affiliation: Departments of Neurology, School of Medicine and Biomedical Sciences USA.
authors.forename: Muhammad W
authors.initials: MW
authors.lastname: Masud
authors.affiliation: Departments of Neurosurgery, School of Medicine and Biomedical Sciences USA; Departments of Radiology, School of Medicine and Biomedical Sciences, USA; Departments of Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York, USA; Department of Neurosurgery, Gates Vascular Institute/Kaleida Health, Buffalo, N.Y., USA.
authors.forename: Elad I
authors.initials: EI
authors.lastname: Levy
authors.affiliation: Departments of Neurosurgery, School of Medicine and Biomedical Sciences USA; Departments of Neurology, School of Medicine and Biomedical Sciences USA; Departments of Radiology, School of Medicine and Biomedical Sciences, USA; Departments of Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York, USA; Department of Neurosurgery, Gates Vascular Institute/Kaleida Health, Buffalo, N.Y., USA.
authors.forename: Kenneth V
authors.initials: KV
authors.lastname: Snyder
authors.affiliation: Departments of Neurosurgery, School of Medicine and Biomedical Sciences USA; Departments of Radiology, School of Medicine and Biomedical Sciences, USA; Departments of Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York, USA; Department of Neurosurgery, Gates Vascular Institute/Kaleida Health, Buffalo, N.Y., USA; Jacobs Institute, Buffalo, N.Y., USA.
authors.forename: Adnan H
authors.initials: AH
authors.lastname: Siddiqui
keywords: Computed tomographic perfusion imaging; Venous sinus thrombosis