Division of Neurology, Department of Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore.
J Clin Neurosci. 2011 Oct;18(10):1408-11. doi: 10.1016/j.jocn.2011.02.030. Epub 2011 Jul 20.
Isolated cortical vein thrombosis (ICVT) in the absence of sinus or great venous involvement is rare. Various MRI sequences have been proposed for diagnostic accuracy, although follow-up data are limited. The optimal management strategy remains uncertain. Patients with ICVT treated between 2006 and 2008 were retrospectively studied. Diagnostic and follow-up neuroimaging were reviewed independently, and we evaluated their treatment and outcomes. Five patients (mean age 41 years; range, 25-54 years) were included. All presented with seizures. Focal neurological deficits were noted in one patient only. T2 susceptibility-weighted MRI abnormalities were observed in all patients. T2-weighted parenchymal hyperintensities involving the cortical-subcortical regions around the ICVT had completely resolved on follow-up scans. Clinical outcomes were uniformly good, despite variable treatment strategies. We observed significant, yet reversible, parenchymal T2-weighted MRI lesions in our patients with ICVT. Follow-up clinical and radiological studies demonstrate recovery independent of treatment regimes. T2-weighted MRI was found to be a useful diagnostic tool and might improve diagnostic accuracy in carefully selected patients with new-onset seizures.
孤立性皮质静脉血栓形成（ICVT）在没有窦或大静脉受累的情况下很少见。已经提出了各种 MRI 序列来提高诊断准确性，但随访数据有限。最佳管理策略仍不确定。回顾性研究了 2006 年至 2008 年期间治疗的 ICVT 患者。独立审查了诊断和随访神经影像学，并评估了他们的治疗和结果。共纳入 5 例患者（平均年龄 41 岁；范围 25-54 岁）。所有患者均出现癫痫发作。仅 1 例患者出现局灶性神经功能缺损。所有患者均观察到 T2 磁敏感加权 MRI 异常。ICVT 周围皮质-皮质下区域的 T2 加权脑实质高信号在随访扫描中完全消退。尽管治疗策略不同，但临床结局均良好。我们观察到伴有 ICVT 的患者存在明显但可逆转的脑实质 T2 加权 MRI 病变。随访的临床和放射学研究表明，独立于治疗方案而恢复。T2 加权 MRI 是一种有用的诊断工具，可能会提高新发性癫痫发作的精心选择患者的诊断准确性。
