Case Report: Contrast Imaging in the Setting of Cerebral Venous Thrombosis

Disruption to contrast agent supply chains for radiology investigations has become an additional consequence of the COVID-19 pandemic. Various recommendations, including dose reductions and choices of alternative agents, have been made to help account for this limited availability. This case demonstrated how two separate computed tomography (CT) venograms with different contrast agents and similar timing, undertaken on the same day for the same patient, yielded different results; cerebral venous thromboses were more prominent in the subsequent scan. Although there were features suggestive of thrombosis on the first scan, repeat imaging was required to further characterize the lesions identified. The case exemplifies the notion that diagnostic imaging should always be guided by a detailed history and examination. It also raises the discussion point of whether more strict or uniform protocols should be developed to facilitate contrast administration for radiology investigations. It is important that appropriate doses are always administered to maximize diagnostic yield.