TY - JOUR
T1 - The empty delta sign
T2 - Frequency and significance in 76 cases of dural sinus thrombosis
AU - Virapongse, C.
AU - Cazenave, C.
AU - Quisling, R.
AU - Sarwar, M.
AU - Hunter, S.
PY - 1987
Y1 - 1987
N2 - The presence of the empty delta sign on contrast material-enhanced computed tomographic (CT) scans of the brain is considered pathognomonic of sagittal sinus thrombosis (SST); however, a valid explanation for its appearance is lacking, despite several hypotheses. To determine the frequency of the sign and its prognostic significance, 76 reported cases (112 CT manifestations) of SST and SST-related intracranial sinovenous occlusive disease were reviewed. Ten CT signs related to both disease processes were reported; the empty delta sign was the most frequently reported sign (28.6%) of SST. Patients with hemorrhagic infarction and/or the empty delta sign on CT scans had the poorest prognosis. A case illustrative of the empty delta sign is described in which there was engorgement of endothelial- and nonendothelial-lined spaces in the dura mater with hemorrhagic rupture into the dural leaf. The empty delta sign can probably be explained on the basis of the rich dural venous collateral circulation, consisting primarily of lateral lacunae, a vascular mesh (dural cavernous spaces), and meningeal venous tributaries.
AB - The presence of the empty delta sign on contrast material-enhanced computed tomographic (CT) scans of the brain is considered pathognomonic of sagittal sinus thrombosis (SST); however, a valid explanation for its appearance is lacking, despite several hypotheses. To determine the frequency of the sign and its prognostic significance, 76 reported cases (112 CT manifestations) of SST and SST-related intracranial sinovenous occlusive disease were reviewed. Ten CT signs related to both disease processes were reported; the empty delta sign was the most frequently reported sign (28.6%) of SST. Patients with hemorrhagic infarction and/or the empty delta sign on CT scans had the poorest prognosis. A case illustrative of the empty delta sign is described in which there was engorgement of endothelial- and nonendothelial-lined spaces in the dura mater with hemorrhagic rupture into the dural leaf. The empty delta sign can probably be explained on the basis of the rich dural venous collateral circulation, consisting primarily of lateral lacunae, a vascular mesh (dural cavernous spaces), and meningeal venous tributaries.
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U2 - 10.1148/radiology.162.3.3809494
DO - 10.1148/radiology.162.3.3809494
M3 - Article
C2 - 3809494
AN - SCOPUS:0023153749
SN - 0033-8419
VL - 162
SP - 779
EP - 785
JO - RADIOLOGY
JF - RADIOLOGY
IS - 3
ER -