Sthanu Subramanian: CVST as The ‘Great Masquerader’ with Normal Initial CT
Sthanu Subramanian, Pediatrician, shared Sudhir Kumar’s post on X:
“Cerebral Venous Sinus Thrombosis (CVST) is indeed a ‘great masquerader’ in neurology, and while non-contrast computed tomography (NCCT) is often the first-line imaging study due to its availability, it can be falsely reassuring.
NCCT may be normal in up to 30% of cases, particularly in the early or subacute stages.”
Sudhir Kumar, Neurologist at Apollo Hospitals, shared a post on X:
“(For doctors- Neurology Case Discussion)
CT Brain is normal… but something is clearly wrong.
- A 37-year-old man presented with 1-month headache (mostly right-sided)
- Headache occurs daily, associated with recurrent vomiting
- No history of fever
- One week back: CT brain and CSF analysis done elsewhere: Normal
- Referred to me for second opinion.
What is the likely diagnosis?
A) Migraine
B) Idiopathic intracranial hypertension
C) Cerebral venous sinus thrombosis
D) Viral encephalitis
MRI FLAIR and MRI Venogram pictures are attached.
What are the findings?
Key clues:
- Subacute progressive headache
- Signs of raised ICP (vomiting)
- Normal CT (don’t be reassured!)
- MRV is the game-changer
Answer:
C) Cerebral venous sinus thrombosis
- MR Venogram shows Non-visualization of a major venous sinus, along with collateral venous channels
- MRI brain may be normal early; don’t miss this.
Teaching pearl:
‘Normal CT scan with persistent headache and vomiting means Think of CVST and Do MRV.’
Miss this, and the consequences can be devastating.”
Other posts featuring Sthanu Subramanian on Hemostasis Today.
-
Oct 21, 2026, 00:58Anees Ur Rahman: Completing a Two-Week Clinical Rotation at Haemophilia Treatment Centre Rawalpindi
-
Oct 21, 2026, 00:56Caitlyn Mooney: Pulmonary Embolism in Athletes, Recognition and Return to Sport
-
Oct 21, 2026, 00:54Hani Karrar: Pleased to Share Our Review on Emicizumab in Hemophilia A Management
-
Oct 21, 2026, 00:53Akshay Sharma: HSCT Leads to Sustained Improvements in Sickle Cell Cardiomyopathy for Up to 3 Years
-
Oct 21, 2026, 00:51Prateek Meena: The F. A. T. R. N. Mnemonic for Recognizing TTP
-
Oct 20, 2026, 23:51Registration Is Open for WFH CCS 2027 – World Federation of Hemophilia
-
Oct 20, 2026, 23:44Edward Lee Carter: AF in Nursing Homes – When Stroke Risk Scores Tell Only Part of the Story
-
Oct 20, 2026, 22:59Building Effective Patient Advocacy Through Collaboration Between Patients and Clinicians – EHC
-
Oct 20, 2026, 21:22Intezar Mehdi: When Prolonged Bleeding May Indicate an Underlying Bleeding Disorder