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 41years; range, 25–54years) 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. [Copyright &y& Elsevier]