title: The clinico-radiological spectrum of isolated cortical vein thrombosis.
abstract: Isolated cortical vein thrombosis (ICVT) in the absence of sinus or great venous involvement is rare. Various MRI sequences have been proposed for diagnostic accuracy, although follow-up data are limited. The optimal management strategy remains uncertain. Patients with ICVT treated between 2006 and 2008 were retrospectively studied. Diagnostic and follow-up neuroimaging were reviewed independently, and we evaluated their treatment and outcomes. Five patients (mean age 41 years; range, 25-54 years) were included. All presented with seizures. Focal neurological deficits were noted in one patient only. T2 susceptibility-weighted MRI abnormalities were observed in all patients. T2-weighted parenchymal hyperintensities involving the cortical-subcortical regions around the ICVT had completely resolved on follow-up scans. Clinical outcomes were uniformly good, despite variable treatment strategies. We observed significant, yet reversible, parenchymal T2-weighted MRI lesions in our patients with ICVT. Follow-up clinical and radiological studies demonstrate recovery independent of treatment regimes. T2-weighted MRI was found to be a useful diagnostic tool and might improve diagnostic accuracy in carefully selected patients with new-onset seizures.
authors.affiliation: Division of Neurology, Department of Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore. rahulrathakrishnan@yahoo.com.sg
authors.forename: Rahul
authors.initials: R
authors.lastname: Rathakrishnan
authors.forename: Vijay K
authors.initials: VK
authors.lastname: Sharma
authors.forename: Teoh Hock
authors.initials: TH
authors.lastname: Luen
authors.forename: Bernard P L
authors.initials: BP
authors.lastname: Chan
mesh_terms: D000328:Adult; D002550:Cerebral Veins / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020767:Intracranial Thrombosis / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012640:Seizures / Q000000981:diagnostic imaging* / Q000209:etiology; D020246:Venous Thrombosis / Q000150:complications / Q000000981:diagnostic imaging*