Abstract
The purpose of this manuscript is to present two cases of unilateral internal cerebral vein thrombosis (UICVT) and use them to review the typical imaging findings and clinical presentation, provide a differential diagnosis when presented with a unilateral thalamic lesion, and discuss current literature findings of internal cerebral vein thrombosis, including the interesting trend of left-sided involvement. Two cases of UICVT were gathered from our institutions. A literature review was then conducted, and cases in the literature were compared to look for common features. Both of our cases involved the left internal cerebral vein. A total of 7 cases of unilateral and 8 cases of bilateral internal cerebral vein thrombosis were reviewed from the literature. Of the unilateral cases, all but one were on the left, and the one on the right was in a patient with right-sided malignancy after surgical resection. Most of these cases completely resolved with anticoagulation. UICVT is an extremely rare entity, with less than 10 cases reported in the literature. The prognosis of this disease is excellent if diagnosed and treated early; however, with delayed diagnosis and treatment, this process can be fatal. This highlights the importance of keeping this diagnosis on the differential when presented with a unilateral thalamic lesion.
Highlights
Cerebral vein thrombosis is an uncommon cause of stroke, with an estimated incidence ranging from 0.2 to 1.3 cases per 100,000 per year [1]
When the MR was obtained, it was noted that there was non-enhancement of the left internal cerebral vein, raising concern for a rare unilateral internal cerebral vein thrombosis
Thrombosis of the cerebral venous system is an uncommon cause of stroke, accounting for approximately 0.2 to 1.3 stroke cases per 100,000 per year [1]
Summary
Cerebral vein thrombosis is an uncommon cause of stroke, with an estimated incidence ranging from 0.2 to 1.3 cases per 100,000 per year [1]. Only an estimated 11% involves the deep cerebral veins [2]. When internal cerebral vein thrombosis occurs, the most common finding is bilateral thalamic infarction, with possible involvement of the adjacent. There have been cases of unilateral thalamic infarction, but still in the setting of bilateral internal cerebral vein thrombosis. Few cases of unilateral internal cerebral vein thrombosis are seen, with only a handful published in the literature. We will present two cases of unilateral internal cerebral vein thrombosis (UICVT), and use them to review the typical imaging findings and clinical presentation, provide a differential diagnosis when presented with a unilateral thalamic lesion, and discuss current literature findings of internal cerebral vein thrombosis, including the interesting trend of left-sided involvement
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