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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May 13, 2026, 17:38Rohit Sankar J. Snscphysio: Recognizing the Clot Before It Becomes Life-Threatening
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May 13, 2026, 16:41Seema Dawood: When Elevated Platelets Signal a Myeloproliferative Neoplasm
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May 13, 2026, 16:38Kari Tikkinen: Defining Thromboprophylaxis in MIBC Neoadjuvant Care
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May 13, 2026, 16:28Nadia Tarhini: Evaluating the Risk of Recurrent Thrombosis in Children with ALL
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May 13, 2026, 16:01Sifat Jubaira: When Low MCV Meets High Platelets
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May 13, 2026, 15:58Aktham El-rekaby: Immunothrombosis in Acute Ischaemic Stroke
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May 13, 2026, 15:49Alison Dougall: Oral Health and Cardiovascular Risk in Bleeding Disorders
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May 13, 2026, 15:38International Journal of Stroke: Oral Anticoagulants and DOAC–Antiplatelet Therapy Are Associated with Increased Major Bleeding Risk
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May 13, 2026, 15:19Papa Heme։ Causes of Isolated Prolonged aPTT Without Bleeding