[Diagnosis of acute phase of venous infarction by diffusion-weighted image: case report and review of the literature].
Diffusion-weighted imaging (DWI) can diagnose early stage not only of the arterial infarction but also of venous infarction. We successfully diagnosed a case as acute venous infarction by DWI. The patient, an infant of one year and ten months, presented disturbance of consciousness and left hemiparesis two weeks after dehydration and infections. Computed tomographic scan revealed a cerebral hemorrhage in the right parietal lobe. Cerebral angiography revealed no contrast filling of the posterior side of superior sagittal sinus, straight sinus and transverse sinus. DWI demonstrated a large hyperintensity lesion around the hematoma, suggesting venous infarction in the early stage. We thought that venous infarction was caused by secondary extension of thrombus to cerebral cortical veins and deep cerebral veins. External decompression and postoperative hypothermia therapy were performed because of rapidly deteriorating intracranial hypertension. Intracranial hypertension was, however, uncontrollable. The patient died four days after the onset. Diagnosis of the venous infarction by DWI was discussed along with other recent reports. Diffusion hyperintensity was displayed in almost all subjects with acute venous infarction. DWI pattern of venous infarction is more heterogeneous than that of arterial one because pathway from venous obstruction to infarction is complicated.
Ogami
R
R
Department of Neurosurgery, Hiroshima University School of Medicine, Kasumi 1-2-3, Minamiku, Hiroshima 734-8551, Japan.
Ikawa
F
F
Kiura
Y
Y
Iida
K
K
Ohba
S
S
Saito
T
T
Arita
K
K
Kurisu
K
K
D002544:Cerebral Infarction / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004058:Diffusion; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012851:Sinus Thrombosis, Intracranial / Q000175:diagnosis*