Abstract
Cerebral venous thrombosis (CVT) is an uncommon cause of stroke with diverse etiologies and varied clinical presentations. Because of variability in clinical presentation and neuroimaging, CVT remains a diagnostic challenge. Recently, some studies have highlighted the value of T2∗-weighted gradient-echo MRI (T2∗WI) in the diagnosis of CVT. We report the case of a 79-year-old woman with CVT due to a hypercoagulable state associated with cancer. On the initial T2-weighted image (T2WI), there was a diffuse high-intensity lesion in the right thalamus, extending into the posterior limb of the internal capsule and midbrain. T2∗WI showed diminished signal and enlargement of the right basilar vein and the vein of Galen. Even though there is a wide range of differential diagnoses in unilateral thalamic lesions, and a single thalamus lesion is a rare entity of CVT, based on T2∗WI findings we could make an early diagnosis and perform treatment. Our case report suggests that T2∗WI could detect thrombosed veins and be a useful method of early diagnosis in CVT.
Highlights
Cerebral venous thrombosis (CVT) is an uncommon cause of stroke with diverse etiologies and varied clinical presentations
The novel finding in our patient is that T2∗-weighted gradient-echo MRI (T2∗WI) was a useful tool for the early diagnosis of CVT
Our case demonstrated that T2∗WI could detect thrombosed veins
Summary
Cerebral venous thrombosis (CVT) is an uncommon cause of stroke with diverse etiologies and varied clinical presentations. Selim et al have highlighted the value of T2∗WI, which show the thrombosis as a hypointense signal associated with the magnetic susceptibility effect [3, 4]. They have reported that the T2∗-weighted MR sequence can be useful in rapid detection of CVT and may enable the diagnosis to be made prior to MR venography (MRV) [3]. We describe a rare case of CVT with unilateral thalamic lesion in which we could detect the thrombosed veins with T2∗WI This finding led us to the early diagnosis of CVT
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