Isolated cortical vein thrombosis: a rare cause of venous stroke with good prognosis after timely diagnosis and treatment

Abstract

Background: Isolated cortical vein thrombosis (ICoVT) is a rare condition representing approximately 6% of cerebral vein thromboses (CVT). In all its forms, CVT is more prevalent in women. ICoVT shares the same group of predisposing conditions typical of other CVT. It may thus be easily missed due to its non-specific clinical presentation and confounding radiological findings, which may lead to a delay in appropriate diagnosis and treatment.

Methods: A comprehensive literature search was conducted to identify manuscripts discussing epidemiology, risk factors, clinical presentation, radiological techniques and presentation, management, and outcome in patients with ICoVT.

Results: We identified 40 papers published between 1991 and 2012 that met our criteria for review.

Discussion: MR techniques are essential in the diagnosis of this entity. Without appropriate therapy, these thromboses may extend bidirectionally and even compromise the dural sinuses. Correction of predisposing factors for venous thrombosis and anticoagulation is the therapy of choice for most patients. The overall prognosis with adequate and timely therapy is very good.

Keywords:

• Anticoagulation
• Cerebral hemorrhage
• Cortical vein thrombosis
• Hemorrhagic transformation
• Ischemic stroke

The editors wish to thank Shifra Fraifeld, a Senior Medical Writer in the Departments of Neurosurgery and Radiology, for her editorial assistance in the preparation of this manuscript.