Efficacy of t2∗-weighted gradient-echo MRI in early diagnosis of cerebral venous thrombosis with unilateral thalamic lesion.

Cerebral venous thrombosis (CVT) is an uncommon cause of stroke with diverse etiologies and varied clinical presentations. Because of variability in clinical presentation and neuroimaging, CVT remains a diagnostic challenge. Recently, some studies have highlighted the value of T2∗-weighted gradient-echo MRI (T2∗WI) in the diagnosis of CVT. We report the case of a 79-year-old woman with CVT due to a hypercoagulable state associated with cancer. On the initial T2-weighted image (T2WI), there was a diffuse high-intensity lesion in the right thalamus, extending into the posterior limb of the internal capsule and midbrain. T2∗WI showed diminished signal and enlargement of the right basilar vein and the vein of Galen. Even though there is a wide range of differential diagnoses in unilateral thalamic lesions, and a single thalamus lesion is a rare entity of CVT, based on T2∗WI findings we could make an early diagnosis and perform treatment. Our case report suggests that T2∗WI could detect thrombosed veins and be a useful method of early diagnosis in CVT.