title: Reversible MR imaging abnormalities following cerebral venous thrombosis.
abstract: OBJECTIVE
  Although rare, cerebral venous thrombosis (CVT) is being diagnosed more frequently owing to improved imaging techniques. The venous infarcts caused by CVT in 50% of patients are largely reversible and differ from arterial stroke. Our purpose was to study the time-dependent changes of venous infarcts on MR images and to define the variables that influence lesion volume in humans.
  
  
  METHODS
  MR images and venous angiograms were evaluated in 15 consecutive patients with venous infarcts due to CVT of sinus, cortical, or internal veins. All patients were treated with intravenous dose-adjusted heparin followed by oral anticoagulation for 12 months. Reduction of signal intensity changes on T1- and T2-weighted images was correlated to the degree of recanalization, age, initial absolute lesion size, and hemorrhage.
  
  
  RESULTS
  Within the first 30 days, we found a significant correlation between the volume of the lesion on T1-weighted images and recanalization. However, early recanalization did not influence the final lesion volume after 12 months. Eleven patients showed complete resolution of changes on T1- and T2-weighted images. Age of the patients influenced initial absolute volume of brain damage.
  
  
  CONCLUSIONS
  In venous stroke, even large parenchymal changes can resolve completely independent from recanalization of the thrombosed veins and sinuses. A plausible hypothesis is that venous infarcts largely consist of a persistent edema and that the lesion volume is influenced by the development of collateral veins. However, further investigations are necessary to understand the underlying abnormal mechanisms.
authors.affiliation: Department of Neurology Justus-Liebig-University, Giessen, Germany.
authors.forename: Carina
authors.initials: C
authors.lastname: Röttger
authors.forename: Susan
authors.initials: S
authors.lastname: Trittmacher
authors.forename: Tibo
authors.initials: T
authors.lastname: Gerriets
authors.forename: Franz
authors.initials: F
authors.lastname: Blaes
authors.forename: Manfred
authors.initials: M
authors.lastname: Kaps
authors.forename: Erwin
authors.initials: E
authors.lastname: Stolz
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000375:Aging; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000209:etiology*; D002550:Cerebral Veins / Q000473:pathology; D015331:Cohort Studies; D004334:Drug Administration Schedule; D005260:Female; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007275:Injections, Intravenous; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D016037:Single-Blind Method; D013997:Time Factors; D020246:Venous Thrombosis / Q000150:complications* / Q000188:drug therapy
chemical_list: D000925:Anticoagulants; D006493:Heparin