[Case of straight sinus venous thrombosis presenting as depression and disorientation due to bilateral thalamic lesions].

A 45-year-old man was admitted to our hospital because of progressive inactivity and mild disturbance of consciousness which appeared two weeks ago. Brain CT revealed symmetric hypointensity of bilateral thalamus, and the lesion appeared hyperintensity on T2 weighted MRI image. He was first considered as immune-mediated cerebritis, and steroid pulse therapy was applied, but the clinical features were not improved. The diagnosis of cerebral venous thrombosis was established, when MR venography (MRV) showed severe stenosis in straight sinus. Consciousness was improved after the start of anticoagulation therapy, but mild dementia was remained as a sequela. MRV was useful to distinguish straight sinus thrombosis from cerebritis in this case.