Unique Features Of Polycythemia Observed On Plain Non Contrast Ct Head

We present a case of Polycythemia secondary to a congenital cardiac anomaly presenting with acute neurological complications showing hyperdense venous sinuses and cerebral vasculature in association with a cerebral abscess. INTRODUCTION Neurological conditions associated with Polycythemia may warrant an emergency non contrast CT scan of the head. The unique findings associated with Polycythemia have not been well characterized in literature. We present a case of Polycythemia associated with hyperdense dural venous sinuses and cerebral vasculature hence simulating the appearance of a contrast enhanced CT on Plain CT films. CASE REPORT A 27 year old male patient presented to our emergency with history of fever and headache for the past 4 days with altered sensorium for 2 days and a brief episode of loss of consciousness two days back. Patient had a history of breathlessness on and off since three years of age. He was diagnosed as a case of heart disease but financial constraints prevented timely treatment. Examination revealed central cyanosis , rt hemiparesis and a pansystolic murmur over the epicardium. NCCT findings were suggestive of a left temporoparietal cerebral abscess associated with hyperdensity of all cerebral venous sinuses and cerebral vasculature. (patient had not been given any intravenous contrast agents ). Figure 1