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Cortical vein thrombosis without sinus involvement is rarely diagnosed, although it may commonly be overlooked.We report four cases of cerebral venous thrombosis limited to the cortical veins.The diagnosis was made on surgical intervention in one patient and by angiography in three patients. Together with a survey of the published cases,the clinical and neuroimaging patterns of our patients allow delineation of several features suggestive of cortical venous stroke.Focal or generalized seizures followed by hemiparesis,aphasia,hemianopia,or other focal neurologic dysfunction in the absence of signs of increased intracranial pressure should suggest this possibility,Neuroimaging(CT,MRI)shows an ischemic lesion that does not follow the boundary of arterial territories and often has a hemorrhagic component,without signs of venous sinus thrombosis.Conventional angiography demonstrates no arterial occlusion but may show cortical vein thrombosis corresponding to the infarct,although these may also be nonspecific findings.The role of MR angiography,which is well-established is sinus thrombosis,remains to be assessed in patients with brain ischemia due to isolated cortical vein occlusion. |
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angiography,cerebral
aphasia
CAT scan,cord sign
cerebral infarction
cerebral infarction,hemorrhagic
cerebral venous thrombosis
cerebrovascular accident
cerebrovascular accident,work up for
cortical vein thrombosis
headache
hemianopia
hemiparesis
misdiagnosis
MRI
MRI,abnormal
MRI,angiography
MRI,false negative
prognosis
review article
seizure
seizure,focal
subcortical hemorrhage
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