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.
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Jun 2, 2026, 19:42Sékouba Sidimé: vWD vs Hemophilia A – The Classic USMLE Step 1 trap in Hematology
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Jun 2, 2026, 19:41Bassem M. Mohammed: How Factor VIII Interacts To Procoagulant Membranes To Support Activation Of Blood Clotting
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Jun 2, 2026, 19:28Looking Beyond Bleeding Control To Understand Inflammation In Hemophilic Arthropathy – CRH French Reference Center for Hemophilia Lyon
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Jun 2, 2026, 19:27Francisco Chacón-Lozsán: Coma Is Not a Diagnosis – Final Pathway Of Brain Arousal And Awareness Failure
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Jun 2, 2026, 19:26Panagiotis Papanagiotou: Recognizing CVST On T2 MRI
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Jun 2, 2026, 17:56Coralie Delporte Gravouil: Scientific Program 2026 – Essentials of Hemostasis Now Available
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Jun 2, 2026, 17:55Anna Rivera: Hemophilia Management – A Shift from Traditional IV Therapies to Novel Subcutaneous Agents
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Jun 2, 2026, 17:53Zoya Surayya: My Thesis on Anticoagulation After Ischemic Stroke
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Jun 2, 2026, 17:49Jeffrey Hall: A Pivotal Moment to Protect Rhode Island Wildlife from Anticoagulant Rodenticides