Article Figures & Data
Figures
- Fig 1.
CT and MR images obtained in a 47-year-old woman with unilateral thrombosis of the left ICV.
A, Nonenhanced cerebral CT scan shows a circumscribed hypoattenuation in the left thalamus and adjacent internal capsule (white arrowheads).
B, Hyperintense area of edema on T2-weighted MR image corresponds to hypoattenuation in A.
C, T1-weighted MR image shows high signal intensity in the left ICV (small white arrowheads) that is strongly indicative of an intraluminal clot.
D, After contrast material administration, the left ICV is unidentifiable in its entire length (large white arrowhead).
E, Intraluminal irregularities and filling defects in the dorsal portion of the ICV (large white arrowhead), together with findings in D, confirm the diagnosis of unilateral ICV thrombosis.
F and G, MR images obtained 2 years after unilateral ICV thrombosis show complete recanalization of the left ICV and no residual parenchymal defects (T2-weighted and T1-weighted).
Tables
Review of the literature: presentation, diagnostic imaging, and outcome of internal cerebral venous thrombosis
Author Patients (No.) Signs and Symptoms Thrombosed Veins Diagnostic Imaging/Validation Location of Lesions Outcome Johnsen et al 1973 (27) 2 infants V, fever, diarrhea ICV, SS, VG autopsia TT, BG, HT hemorrhage Death V, lethargy ICV, VG, SS CA −TT, hydroceph Residual deficits Yoshii et al 1978 (9) 1 −HA, fever, DC, coma DCV, VG, SS NECT, CA −ventricular dilatation n.a. Forsting et al 1989 (6) 1 HA, BA, DM, HP ICV, VG, SS, RTV NECT, MRI −unilateral, then TT Almost recovery Haley et al 1989 (10) 1 HA, NV, confusion ICV, VG, SS NECT, CA −TT Mnestic deficits DM, amnesia Erbguth et al 1991 (8) 3 A, DC, HP ICV, SS NECT, CA −TT, BG Residual deficit A, DC, hemianopsia ICV, VG, SS, SSS NECT, MRI −TT, hemorrhage Recovery n.a. VG, SS −LT hemorrhage Recovery Bell et al 1994 (1) 3 Confusion DCV, DS MRI, MRA −TT Residual deficits Confusion DCV, DS MRI, MRA −TT, BG Recovery Coma, seizure DCV MRI, MRA, CA −TT, BG Death Crawford et al 1995 (2) 7 −HA, NV; −ICV, VG, SS NECT, MRI, CA −TT, hydroceph Severe disability −HA; NV, DC −ICV, VG, SS, SSS NECT,autopsy n.a. Death −HA; NV, DM −ICV, VG, SS, SSS autopsy n.a. Death −HA, fever, DM −ICV, VG, SS, SSS, TS NECT,MRI,CA −TT Severe disability −HA, NV −ICV, VG, SS MRI, MRA −TT, BG Stable −Seizures −ICV, VG, SS, SSS NECT,MRI,MRA −TT Seizures controlled −HA, NV, DM −ICV, VG, SS, SSS NECT,MRI,MRA −TT, BG Death Wang et al 1995 (29) 1 Confusion, seizure, BA SSS, DCV MRI, CA −TT, BG, hemorrhage n.a. Förderreuther et al 1997 (7) 1 Amnesia DCV, VG, SS NECT, MRI, CA −TT Recovery Gerszten et al 1997 (12) 1 NV, HA, HP, BA ICV, SS, RTS NECT, MRI, MRA −TT, BG, LT hemorrhage Discrete neurol deficit Magni et al 1998 (13) 2 HA, NV, HP DCV, SS NECT, MRI, CA −TT, BG mesencephalic Death HA, N, BA; DM DCV, VG, SS, LS NECT, MRI, MRA −TT Recovery Rousseaux et al 1998 (5) 1 Amnesic syndrome, dystonia SS, LICV n.a. LT, striatocapsular Residual deficit in verbal recall Note.—symptoms: HA, headache; N, nausea; V, vomiting; HP, hemiparesis; BA, behavioral anomalies; DM, decline in mental status; DC, decline in consciousness; A, aphasia. Veins: DCV, deep cerebral veins; ICV, internal cerebral vein; LICV, left internal cerebral vein; VG, vein of Galen; SS, straight sinus; LS, lateral sinus; (R)TS, (right) transverse sinus; SSS, superior sagittal sinus. Imaging: NECT, nonenhanced CT; CA, conventional angiography; MRI(A), MR imaging (angiography). Locations: LT, left thalamus; RT, right thalamus; TT, both thalami; BG, basal ganglia; HT, hypothalamus; hemorrh., hemorrhagic transformation; hydroc., hydrocephalus; n.a., data not available.
