In utero magnetic resonance imaging for diagnosis of dural venous sinus ectasia with thrombosis in the fetus

Abstract

This is among the largest series of postnatal clinical follow-up in cases of prenatal diagnosis of dural venous sinus ectasia with thrombosis in the literature. Clinical follow-up suggests a good prognosis when antenatal follow-up shows partial or complete thrombus resolution.

Thrombosis of the torcular herophili in the fetus: a series of eight cases

“…Although no data on the prevalence of this condition is available, thrombosis of the torcular herophili is the most frequently diagnosed cerebral thrombotic event during fetal life . As demonstrated by this report and other reviews available in the literature, this condition seems to have a benign antenatal course in a significant number of cases.…”

“…As previously demonstrated, fetal MRI did not modify the diagnosis, but it seems to be helpful to provide additional information in relation to the absence of cerebral parenchymal damage and to rule out the presence of associated cerebral malformations . It may also assist in the determination of the time at which the thrombosis occurred, which may provide important information for subsequent management and parental counseling.…”

“…In contrast to venous thrombosis in the adult, in whom risk factors for cerebral thrombosis and stroke are well established, dural sinus thrombosis in the fetus does not seem to be associated with any specific risk factors . In the vast majority of the reported prenatal cases, a relation with environmental exposures or thrombophilic conditions such as antiphospholipid syndrome has not been demonstrated . Therefore, a vascular anatomical malformation affecting the drainage into the torcular herophili seems to be the most common condition associated with these cases.…”

“…This vascular dilatation is usually associated with low‐velocity blood flow, which may predispose to dural sinus thrombosis as confirmed by postnatal imaging and autopsy studies . However, dural sinus thrombosis in the fetus is a rare cerebrovascular condition invariably affecting the torcular herophili, with fewer than 50 cases reported in the English literature . In these cases, the most striking findings include the presence of a large intracranial thrombus within a distended torcular herophili.…”

“…4,5 However, dural sinus thrombosis in the fetus is a rare cerebrovascular condition invariably affecting the torcular herophili, with fewer than 50 cases reported in the English literature. [6][7][8][9] In these cases, the most striking findings include the presence of a large intracranial thrombus within a distended torcular herophili. Despite this very dramatic sonographic presentation, it can be associated with spontaneous resolution with good perinatal outcome when the thrombosis is an isolated event.…”