Fat in dural sinuses

Case contribution: Dr Radhiana Hassan

  • A 77 year old lady, underlying hypertension and neurofibromatosis 1
  • Currently admitted for hypercalcaemia and investigated for colorectal cancer.
  • In hospital, she had one episode of syncopal attack about one minute and spontaneously regain consciousness.
  • Clinical examination shows: GCS full, power generally 5/5, sensation and reflex are normal.
  • CT scan to look for ICB.
CT scan brain in axial plane, soft tissue and bone window

CT scan findings:

  • There is no hyperdense area to suggest acute intracranial hemorrhage.
  • No hypodense area to suggest cerebral infarctions.
  • No midline shift or mass effect.
  • Tubular hypodense lesion with fat density (mean HU -52) is noted at torcular herophili extending to the straight sinus (red arrows).
  • A few similar and smaller lesions are also noted at the inferior sagittal sinus.
  • Multiple nodular skin lesions in keeping with neurofibromatosis nodules.

Diagnosis: Incidental finding of fat in dural sinuses


  • Small amounts of fat are a common incidental findings in dural sinuses
  • Mostly seen in cavernous sinus, torcular herophili, the straight and transverse sinus (in decreasing order of frequency)
  • These deposits represent normal adipose tissue in the dural sinuses and not lipomas
  • Intracranial lipomas are seen at pericallosal, quadrigeminal cistern, suprasellar, cerebellopontine angle, sylvian fissure and choroid plexus
Author: radhianahassan