title: Isolated cortical vein thrombosis: case series.
abstract: OBJECTIVE
  Isolated cortical vein thrombosis (ICVT) accounts for less than 1% of all cerebral infarctions. ICVT may cause irreversible parenchymal damage, rendering early and accurate diagnosis critical. This case series and literature review presents the clinical and radiological findings in 7 patients with ICVT, and highlights risk factors and imaging modalities that may be most beneficial in rendering an accurate and timely diagnosis.
  
  
  METHODS
  Patients with CT and MRI findings consistent with ICVT examined between January 2011 and June 2014 were included in this retrospective review.
  
  
  RESULTS
  Seven patients (5 females, 2 males), ranging in age from 11 months to 34 years, met the inclusion criteria. The most common clinical presentations were headaches (n = 4) and seizures (n = 3). The most common comorbidities noted in these patients were hypercoagulable states (n = 4) and intracranial hypotension (n = 3). Five patients had intraparenchymal involvement. CT suggested the correct diagnosis in 4 patients, and MRI confirmed the diagnosis in all 7 patients. All patients who received anticoagulation therapy (n = 5) experienced complete resolution of their symptoms.
  
  
  CONCLUSIONS
  The majority of these patients were adult females, consistent with published data. Seizures and headaches were the most common presenting symptoms. Hypercoagulable state and intracranial hypotension, both known risk factors for thrombosis, were the most commonly noted ICVT risk factors. Intraparenchymal involvement was prevalent in nearly all ICVT cases and presented as vasogenic edema, early intraparenchymal hemorrhage, or hemorrhagic venous infarction. Susceptibility-weighted imaging was the most sensitive imaging technique in diagnosing ICVT.
authors: Departments of 1 Neurological Surgery and.
authors: Ranjodh
authors: R
authors: Singh
authors: Departments of 1 Neurological Surgery and.
authors: William P
authors: WP
authors: Cope
authors: Departments of 1 Neurological Surgery and.
authors: Zhiping
authors: Z
authors: Zhou
authors: Department of Neurosurgery, Lenox Hill Hospital, New York, New York.
authors: Michelle E
authors: ME
authors: De Witt
authors: Department of Neurosurgery, Lenox Hill Hospital, New York, New York.
authors: John A
authors: JA
authors: Boockvar
authors: Radiology, Weill Cornell Medical College, NewYork-Presbyterian Hospital; and.
authors: Apostolos J
authors: AJ
authors: Tsiouris
mesh_terms: D000328:Adult; D002550:Cerebral Veins / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D020767:Intracranial Thrombosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D055815:Young Adult
keywords: CTA = CT angiography; CTV = CT venography; DWI = diffusion-weighted imaging; GRE = gradient-recalled echo; ICVT = isolated cortical vein thrombosis; IPH = intraparenchymal hemorrhage; MRV = MR venography; SAH = subarachnoid hemorrhage; SDH = subdural hemorrhage; SPGR = spoiled gradient recalled echo; SWI = susceptibility-weighted imaging; intraparenchymal hemorrhage; isolated cortical vein thrombosis; magnetic resonance imaging; susceptibility-weighted imaging; vascular disorders; venous infarction