Isolated cortical venous thrombosis as a mimic for cortical SAH.

Isolated cortical venous thrombosis as a mimic for cortical SAH.

World Neurosurg. 2016 Jan 20;

Authors: Kim J, Huh C, Kim D, Jung C, Lee K, Kim H

Abstract
Isolated cortical venous thrombosis is very rare and poorly understood. The clinical presentation is also not well described in the literature. We report here a case of isolated cortical venous thrombosis that mimicked cortical subarachnoid hemorrhage (SAH). A 62-year-old man with a history of chronic subdural hemorrhage visited our hospital with headache. Brain computed tomography (CT) revealed a linear hyperdense area in the right central sulcus (cord sign) suggestive of isolated cortical SAH. MRI revealed susceptibility in the corresponding area. CT angiogrphy revealed no specific finding. However, transfemoral cerebral angiography (TFCA) identified filling defects in the right cortical veins. Under of isolated cortical venous thrombosis, anticoagulation therapy was used to prevent the propagation of thrombosis. The patient had no recurrence of his symptoms. If a cord sign is present on non-contrast CT images, further studies (MRI/V or TFCA) should be performed in a stepwise manner. Such considerations could prevent a fatal outcome and poor prognosis.

PMID: 26802867 [PubMed - as supplied by publisher]

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