ARRS Case of the Week
Case Author: Megan K. Strother, MD, Vanderbilt University Medical Center
21-year-old woman with chronic headaches.
Axial T2-weighted MR image (A) shows a rounded hyperintense filling defect in the right transverse sinus. Axial CT angiogram (B) shows the round filling defect. The transverse sinus otherwise appears normal. Anteroposterior cerebral angiogram (C) shows the contrast-opacified transverse sinus with a rounded filling defect (arrow).
- Arachnoid granulation
- Dural arteriovenous fistula
- Dural venous sinus thrombosis
- Transverse sinus hypoplasia
In 96% of cases, arachnoid granulations are associated with a vein. Arachnoid granulations are isointense to CSF in all MRI sequences. Most arachnoid granulations are incidental findings, although they have rarely been reported to cause symptoms due to venous hypertension.
Leach JL, Jones BV, Tomsick TA, Stewart CA, Balko MG. Normal appearance of arachnoid granulations on contrast-enhanced CT and MR of the brain: differentiation from dural sinus disease. AJNR
Lianga L, Korogia Y, Sugaharaa T, et al. Normal structures in the intracranial dural sinuses: delineation with 3D contrast-enhanced magnetization prepared rapid acquisition gradient-echo imaging sequence. AJNR
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