A 50 year old woman presented to the emergency department several hours after the sudden onset of a severe headache with associated neck stiffness, photophobia, and vomiting. She reported having a dental abscess, and was taking norethisterone regularly for persistent vaginal bleeding. She had a 50 pack year smoking history. She was afebrile, alert (Glasgow coma scale 15), and had no focal neurological signs. Blood tests were unremarkable, in particular her white blood cell and neutrophil counts were within the normal range. A non-contrast computed tomography (CT) scan of the head was obtained in the emergency department (fig 1⇓). Fig 1  Non-contrast computed tomography (CT) scan of the head: (A) axial and (B) sagittal views ### 1. What is the diagnosis based on the history and CT scan? #### Short answer Cerebral venous thrombosis, seen by the “dense triangle sign,” a hyperdensity at the posterior part of the superior sagittal sinus (fig 2a⇓), and the “cord sign” (fig 2b⇓), a homogenous hyperdensity that fills a sinus. Diagnosis is usually made from magnetic resonance (MR) or CT venography. Fig 2  Non-contrast CT scan of the …

中文翻译：

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一名50岁妇女突然发作头痛

一名严重头痛突然发作，伴有颈部僵硬，畏光和呕吐的几小时后，一名50岁妇女出现在急诊室。她报告患有口腔脓肿，并定期服用炔诺酮治疗持续性阴道出血。她有50包年吸烟史。她发热，机敏（格拉斯哥昏迷评分15），无局灶性神经系统体征。血液检查无异常，特别是她的白细胞和中性粒细胞计数在正常范围内。在急诊科获得了头部的非对比计算机断层扫描（CT）扫描（图1⇓）。图1头部的非对比计算机断层扫描（CT）扫描：（A）轴向和（B）矢状面### 1.基于病史和CT扫描的诊断是什么？####简短答案脑静脉血栓形成，从“密集三角体征”可以看出，上矢状窦的后部有一个高密度（图2a⇓），而“脐带征”（图2b⇓）则是一个充满窦的同质高密度。诊断通常是通过磁共振（MR）或CT静脉造影进行的。图2…的非对比CT扫描