Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
Neurol India. 2020 Mar-Apr;68(2):373-377. doi: 10.4103/0028-3886.280640.
The diagnosis of isolated cortical vein thrombosis (ICVT) involving superficial middle cerebral vein (SMCV) remains challenging even in the present era of modern MRI protocols.
The purpose of this study is to review the clinical and radiological characteristics of SMCV thrombosis in our hospital.
Chart review of cases of SMCV thrombosis admitted in a tertiary care university hospital in South India during a 1-year period from September 2015 to August 2016.
Five SMCV thrombosis patients were identified and presented with focal seizures. Neuroimaging showed edema (with or without hemorrhage) of cortex and white matter of inferior frontal gyrus, temporal pole, superior temporal gyrus, insular cortex, and external capsule. The thrombosis of SMCV was demonstrated by Spin echo T1-weighted, GRE-weighted axial, and postcontrast T1-weighted images in coronal and sagittal planes, with a slice thickness of <3 mm. Four received anticoagulation and all improved rapidly and completely.
SMCV thrombosis should be considered in patients having recent onset seizures in appropriate setting based on MRI evidence of parenchymal edema and/or hemorrhage in the perisylvian region along with evidence of thrombosed vein in that region. Appropriate imaging sequences help in confirmation of diagnosis.
即使在现代 MRI 方案的时代，涉及浅表大脑中静脉（SMCV）的孤立性皮质静脉血栓形成（ICVT）的诊断仍然具有挑战性。
本研究旨在回顾我院 SMCV 血栓形成的临床和影像学特征。
对 2015 年 9 月至 2016 年 8 月期间在印度南部一家三级护理大学医院住院的 SMCV 血栓形成病例进行图表回顾。
确定了 5 例 SMCV 血栓形成患者，均表现为局灶性癫痫发作。神经影像学显示额下回、颞极、颞上回、岛叶皮质和外囊的皮质和白质水肿（伴或不伴出血）。SMCV 血栓形成通过自旋回波 T1 加权、GRE 加权轴位和冠状位及矢状位对比后 T1 加权图像显示，层厚<3mm。4 例接受抗凝治疗，所有患者均迅速完全改善。
根据 MRI 证据，在适当的情况下，SMCV 血栓形成应考虑在近期出现癫痫发作的患者中，提示在侧裂区有实质水肿和/或出血，以及该区域血栓形成的证据。适当的成像序列有助于确诊。
