Posterior Lumbar Interbody Fusion and Repeated Adjacent Segment Disease: An Important Issue with Profound Impact

Abstract

Cerebral venous thrombosis (CVT), a rare cerebrovascular condition, is induced by blocked cerebral venous reflux, often presenting nonspecific symptoms. Magnetic resonance imaging (MRI) of the brain may improve the often elusive diagnosis of CVT. However, the sensitivity, specificity, and full spectrum of such MRI findings are poorly understood.We report the case of a 53-year-old male patient with CVT. The patient complained of a severe headache in addition to an enhanced lesion on contrasted T1-weighted MR images, which was originally considered an angiogenic tumor. However, surgery and pathology confirmed the case to be CVT. After surgery and administration of an anticoagulation agent, the patient's symptoms alleviated, and cranial MRI and computed tomography 1 month after surgery showed no abnormalities.We conclude that such cases may occur where CVT appears tumor-like on MRI, including mass effect and abnormal contrast enhancement. Therefore, for young and middle-aged adults with episodic and progressive headaches presenting such MRI findings, the possibility of CVT should always be considered. MRI combined with MR venography should be used as the preferred strategy for early diagnosis of CVT.