Isolated cortical vein thrombosis: a rare cause of venous stroke with good prognosis after timely diagnosis and treatment

Cohen, José E.; Duck, Michaela; Gomori, John M.; Itshayek, Eyal; Leker, Ronen R.

doi:10.1179/1743132812y.0000000148

Cited by 9 publications

(8 citation statements)

References 32 publications

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“…Coutinho et al found that the most successful diagnostic tool for CCVT was CE-MRV (which had a 73% accuracy rate), followed by conventional angiography (47%) ( 6 ). However, both CE-MRV and DSA diagnose CCVT indirectly, using metrics such as poor blood flow or contrast interruption, and cannot directly demonstrate cortical vein thrombosis ( 2 ).…”

Section: Discussionmentioning

confidence: 99%

“…Previous case reports and case series have described CCVT as isolated cortical venous thrombosis ( 2 ). However, we found that the majority of CCVT cases were comorbid with CVST (15/16).…”

Section: Discussionmentioning

confidence: 99%

“…These factors can also lead to delays in treatment. Isolated cortical vein thrombosis (ICoVT) is an exceedingly rare condition that represents ~6% of all cerebral venous thrombosis (CVT) entities ( 1 , 2 ).…”

Section: Introductionmentioning

confidence: 99%

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High-Resolution Magnetic Resonance Black Blood Thrombus Imaging and Serum D-Dimer in the Confirmation of Acute Cortical Vein Thrombosis

et al. 2021

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Cerebral cortical vein thrombosis (CCVT) is often misdiagnosed because of its non-specific diagnostic symptoms. Here, we analyzed a cohort of patients with CCVT in hopes of improving understandings and treatments of the disease. A total of 23 patients with CCVT (confirmed with high-resolution imaging), who had been diagnosed between 2017 and 2019, were enrolled in this cohort study. Baseline demographics, clinical manifestations, laboratory data, radiological findings, treatment, and outcomes were collected and analyzed. Fourteen females and nine males were enrolled (mean age: 32.7 ± 11.9 years), presenting in the acute (within 7 days, n = 9), subacute (8–30 days, n = 7), and chronic (over 1 month, n = 7) stages. Headaches (65.2%) and seizures (39.1%) were the most common symptoms. Abnormally elevated plasma D-dimers were observed in the majority of acute stage patients (87.5%). The diagnostic accuracy of contrast-enhanced magnetic resonance venography (CE-MRV) and high-resolution magnetic resonance black-blood thrombus imaging (HR-MRBTI) in detecting CCVT were 57.1 and 100.0%, respectively. All patients had good functional outcomes after 6-month of standard anticoagulation (mRS 0–1) treatment. However, four CCVT patients that had cases involving multiple veins showed symptom relief after batroxobin therapy (p = 0.030). HR-MRBTI may be a fast and accurate tool for non-invasive CCVT diagnosis. HR-MRBTI combined with D-dimer can also precisely identify the pathological stage of CCVT. Batroxobin may safely accelerate cortical venous recanalization in combination with anticoagulation. Follow-up studies with larger sample sizes are suggested to evaluate the safety and efficacy of batroxobin for treating CCVT.

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Section: Discussionmentioning

confidence: 99%

“…Previous case reports and case series have described CCVT as isolated cortical venous thrombosis ( 2 ). However, we found that the majority of CCVT cases were comorbid with CVST (15/16).…”

Section: Discussionmentioning

confidence: 99%

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High-Resolution Magnetic Resonance Black Blood Thrombus Imaging and Serum D-Dimer in the Confirmation of Acute Cortical Vein Thrombosis

et al. 2021

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“…CVT is a relatively uncommon but potentially life-threatening condition, accounting for 1–2% of strokes in young adults ( 6 ). CVT includes dural sinus thrombosis, deep venous thrombosis and ICoVT.…”

Section: Discussionmentioning

confidence: 99%

Pathological confirmation of 4 cases with isolated cortical vein thrombosis previously misdiagnosed as brain tumor

Ren

Yao

et al. 2015

Oncology Letters

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Isolated cortical vein thrombosis (ICoVT) is a rare form of cerebral venous thrombosis and is easily misdiagnosed as brain tumor due to its atypical clinical presentations and radiological findings similar to brain tumors. The present study focused on 4 patients with ICoVT, 2 men and 2 women. In the 2 male patients, the onset of disease was insidious, with progressive numbness and weakness in limbs as the major symptoms. By contrast, 2 female patients suffered from acute onset of symptoms, presenting with headache and seizures. Brain computed tomography and magnetic resonance imaging showed large hemorrhagic lesions surrounded by massive edemas in the 4 patients. Brain biopsies were performed in the 4 patients due to concern for brain tumors. However, the pathological results supported the diagnosis of ICoVT, and the subsequent anticoagulant treatment administered was effective for all 4 patients. In conclusion, ICoVT can be easily misdiagnosed as brain tumor because of the atypical clinical and imaging features. The results suggested that the possibility of ICoVT always be considered in patients with neuroimaging showing cortical hemorrhagic lesions with massive edemas.

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“…Isolated CVT without venous sinus involvement is rare, occurring in 6% of cerebral venous thrombosis,2 though this finding may be overlooked. The underlying mechanism remains unclear.…”

Section: Descriptionmentioning

confidence: 99%

Not just another thunderclap headache: a case of isolated cortical vein thrombosis and subarachnoid haemorrhage

2015

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Isolated cortical vein thrombosis: a rare cause of venous stroke with good prognosis after timely diagnosis and treatment

Cited by 9 publications

References 32 publications

High-Resolution Magnetic Resonance Black Blood Thrombus Imaging and Serum D-Dimer in the Confirmation of Acute Cortical Vein Thrombosis

High-Resolution Magnetic Resonance Black Blood Thrombus Imaging and Serum D-Dimer in the Confirmation of Acute Cortical Vein Thrombosis

Pathological confirmation of 4 cases with isolated cortical vein thrombosis previously misdiagnosed as brain tumor

Not just another thunderclap headache: a case of isolated cortical vein thrombosis and subarachnoid haemorrhage

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