65yo F presenting to ED with CC of HTN at home. Also admitte | Figure 1

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Case Summary

65yo F presenting to ED with CC of HTN at home. Also admitted to headache of 3 days and now some double vision. Did a CT to r/o bleed. What do y'all see? Try to figure it out before looking at comments.

Diagnostic Images

• Non-Contrast Head CT: Axial non-contrast head CT (images 1 and 2) show a hyperdense clot (arrow) within the posterior aspect of the superior sagittal sinus and ischemic changes (arrowhead) within the anterolateral right frontal lobe, confirmed at a higher level on image 2. Contrast-enhanced images from a CT venogram (images 3 and 4) emphasize the filling defect (arrow) within the superior sagittal sinus. At the level of the torcula (image 4), the clot creates the 'empty delta' sign, indicative of superior sagittal sinus thrombosis, which can result from trauma, infection, or hypercoagulable states.

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