scholarly journals Cerebral venous thrombosis following spontaneous intracranial hypotension diagnosed by craniotomy: A case report and diagnostic pitfalls

2021 ◽  
Vol 12 ◽  
pp. 367
Author(s):  
Shigeomi Yokoya ◽  
Hideki Oka ◽  
Akihiko Hino
Keyword(s):  
Intracranial Hypotension ◽  
Sinus Thrombosis ◽  
Fluid Pressure ◽  
Spontaneous Intracranial Hypotension ◽  
Dural Sinus ◽  
Cerebral Vein ◽  
Imaging Findings ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Cortical Vein Thrombosis

Background: Cerebral vein and dural sinus thrombosis (CVT) is a rare but important complication of spontaneous intracranial hypotension (SIH). The diagnosis is difficult in cases lacking typical symptoms and typical imaging findings. Case Description: A 29-year-old male patient with a seizure attack was admitted to our hospital. Based on the head imaging findings, we misdiagnosed the patient with primary cerebral parenchymal lesion and performed an open biopsy. However, during the procedure, the patient was diagnosed with low cerebrospinal fluid pressure and cerebral cortical vein thrombosis. Conclusion: Thus, CVT due to SIH should be considered as a probable cause of secondary parenchymal lesions.

Prevalence of cerebral vein thrombosis among patients with spontaneous intracranial hypotension

2021 ◽  
pp. 159101992110659
Author(s):  
M Oien ◽  
JK Cutsforth-Gregory ◽  
I Garza ◽  
NR Kissoon ◽  
CM Carr ◽  
...  
Keyword(s):  
Intracranial Hypotension ◽  
Sinus Thrombosis ◽  
Spontaneous Intracranial Hypotension ◽  
Rare Condition ◽  
Cerebral Venous Sinus Thrombosis ◽  
Cerebral Vein ◽  
Imaging Findings ◽  
Arteriovenous Fistulas ◽  
Vein Thrombosis ◽  
Lobar Hemorrhage

Background and purpose Cerebral venous sinus thrombosis (CVST) is a rare condition but an important complication of spontaneous intracranial hypotension (SIH). We reviewed our experience of patients with SIH and assessed for the presence of CVST. Methods We reviewed the medical records and imaging studies from our tertiary referral institution, assessing patients with clinically suspected SIH as well as imaging findings of intracranial hypotension. All relevant brain MRIs were reviewed for the presence of brain sag, pachymeningeal enhancement, and CVST. Results Among 563 patients with a clinical diagnosis of SIH, 431 (76%) demonstrated brain sag. In the overall patient cohort, a total of 5 patients had CVST (0.9%) and all 5 of these patients demonstrated findings of brain sag. Of the patients with CVST, 3 had significant complications, including dural arteriovenous fistulas (2 patients) and lobar hemorrhage with seizure (1 patient). Conclusion SIH is a risk factor for the development of CVST. In our review of 563 patients with clinical and/or imaging findings of SIH, 0.9% of patients were diagnosed with CVST and 3 of these patients (60%) had additional severe complications.

Headache in cerebral venous sinus thrombosis revisited: Exploring the role of vascular congestion and cortical vein thrombosis

Cephalalgia ◽  
2017 ◽  
Vol 38 (3) ◽  
pp. 503-510 ◽  
Author(s):  
Ravinder-Jeet Singh ◽  
Jitender Saini ◽  
Shriram Varadharajan ◽  
Girish Baburao Kulkarni ◽  
Mustare Veerendrakumar
Keyword(s):  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Dural Sinus ◽  
Dural Sinus Thrombosis ◽  
Venous Sinus Thrombosis ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Cortical Vein Thrombosis ◽  
Vascular Congestion

Background and purpose Headache constitutes the most common symptom of cerebral venous sinus thrombosis (CVST), but its pathophysiology is unclear. We sought to investigate the potential mechanism for headache genesis in patients with CVST based on its imaging correlates. Methods A subgroup of CVST patients having headache as the predominant symptom without significant parenchymal lesion were retrospectively analysed for imaging features of vascular congestion (VC), in addition to cortical venous (CVT) and dural sinus thrombosis (DST) on magnetic resonance imaging. Headache and imaging patterns were classified into lateralized and nonlateralized phenotypes and their correlation was sought. Results Among 41 patients included, 28 had lateralized headache (LH group; 15 males; mean age 32.25 ± 9.19 years) while 13 had nonlateralized headache (non-LH group; six males; mean age 27.15 ± 8.65 years). Headache characteristics in both the groups were quite similar. Imaging showed VC in 39 of 41 and CVT among 35 of 41 patients, which were lateralized in 23 of 39 and 18 of 35 patients, respectively. Nearly all lateralized imaging patterns (21 of 23 for VC and 17 of 18 for CVT) occurred in the LH group and ipsilateral to (concordant) headache, while the non-LH group showed lateralized VC and CVT in only two and one patient respectively. Sinus thrombosis was lateralized in both groups irrespective of headache laterality. Whole cohort headache-imaging laterality (including patients with nonlateralized headache and nonlateralized imaging) concordance was 31 of 39, 24 of 35 and 18 of 41 for vascular congestion, cortical vein thrombosis and dural sinus thrombosis respectively. Conclusion Co-localization of VC and CVT with overlying headache might provide a possible explanation of headache and its laterality in patients with CVST.

scholarly journals Cerebellar cortical vein thrombosis mimicking a vermian tumor: case report

2017 ◽  
Vol 31 (3) ◽  
pp. 309-312 ◽  
Author(s):  
Marcelo D Vilela ◽  
Hugo AS Pedrosa ◽  
Marco Antonio D Filho
Keyword(s):  
Case Report ◽  
Sinus Thrombosis ◽  
Cerebellar Hemisphere ◽  
Dural Sinus ◽  
Cerebellar Tumor ◽  
Dural Sinus Thrombosis ◽  
Venous Infarction ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Cortical Vein Thrombosis

Cortical vein thrombosis is an uncommon cause of stroke and generally occurs in the supratentorial compartment. Spontaneous venous thrombosis with infarction in the posterior fossa usually occurs in association with either dural sinus thrombosis and/or thrombosis of the petrosal vein, usually with venous infarction of the cerebellar hemisphere. Our goal is to present the case of a patient with thrombosis of cerebellar cortical veins, without sinus involvement, which mimicked a vermian cerebellar tumor.

Spontaneous Intracranial Hypotension with Isolated Cortical Vein Thrombosis and Subarachnoid Haemorrhage

Cephalalgia ◽  
2007 ◽  
Vol 27 (12) ◽  
pp. 1413-1417 ◽  
Author(s):  
Y-F Wang ◽  
J-L Fuh ◽  
J-F Lirng ◽  
F-C Chang ◽  
S-J Wang
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Venous Thrombosis ◽  
Intracranial Hypotension ◽  
Venous Blood ◽  
Spontaneous Intracranial Hypotension ◽  
Brain Magnetic Resonance Imaging ◽  
Venous Blood Flow ◽  
Cortical Vein ◽  
Cortical Vein Thrombosis ◽  
Cortical Venous Thrombosis

Spontaneous intracranial hypotension (SIH) associated with subarachnoid haemorrhage (SAH) has never been reported. Here, we report on a case of a 33-year-old woman with SIH, who developed simple partial sensory seizures 3 weeks later. Neuroimaging studies, including brain computed tomography and angiography, were initially normal, but revealed an isolated cortical venous thrombosis at 3 weeks. One week later, brain magnetic resonance imaging showed SAH around the thrombosed cortical vein. We postulate that the decline in the venous blood flow velocity due to SIH may have resulted in cortical venous thrombosis, which in turn led to rupture of the vessel wall and SAH in this patient.

Diffusion-Weighted MR Imaging Findings of Cortical Vein Thrombosis at 3 T

2014 ◽  
Vol 25 (3) ◽  
pp. 249-256 ◽  
Author(s):  
M. E. Yıldız ◽  
U. A. Ozcan ◽  
A. Turk ◽  
O. S. Ulus ◽  
C. Erzen ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Imaging Findings ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Diffusion Weighted ◽  
Cortical Vein Thrombosis

scholarly journals Isolated cortical vein thrombosis: case series

2015 ◽  
Vol 123 (2) ◽  
pp. 427-433 ◽  
Author(s):  
Ranjodh Singh ◽  
William P. Cope ◽  
Zhiping Zhou ◽  
Michelle E. De Witt ◽  
John A. Boockvar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intracranial Hypotension ◽  
Vasogenic Edema ◽  
Anticoagulation Therapy ◽  
Case Series ◽  
Published Data ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Presenting Symptoms ◽  
Cortical Vein Thrombosis

OBJECT 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.

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