Question:

Diagnosis of isolated cortical vein thrombosis
1. is classically made on the characteristic history
2. findings on clinical examination are very specific
3. can never be made with certainty
4. is best made with MRI
5. mostly made on autopsy





Answer:

The correct answer for the question "Diagnosis of isolated cortical vein thrombosis" is:

4. is best made with MRI



Explanation

MRI is the most appropriate diagnostic tool as it may enable direct visualization of the thrombus in the affected superficial cortical vein as well as the secondary changes of venous outflow obstruction, seen in the form of swollen gyri as a result of venous congestion.



From the manuscript:
Isolated Cortical Vein Thrombosis - The Cord Sign
Radiology Case. 2009 Mar; 3(3):21-24


This article belongs to the Neuro section.




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From the manuscript

Isolated Cortical Vein Thrombosis - The Cord Sign

Free full text article: Isolated Cortical Vein Thrombosis - The Cord Sign

Abstract
Isolated cortical vein thrombosis is an uncommon condition and often difficult to diagnose, both clinically and radiologically. We report a case of a 38 years old man who presented with headache of new onset and clinical examination was unremarkable. The unenhanced brain CT did not reveal any abnormality. In view of unrelenting headache and partial seizures, we performed magnetic resonance imaging (with axial T1, T2 and gradient echo sequences, coronal FLAIR, diffusion weighted imaging as well as Gadolinium contrast-enhanced images) and magnetic resonance venography of the brain that revealed an isolated parietal cortical vein thrombosis with the rarely reported `cord sign`. We report the clinical and radiological findings in our patient with isolated parietal cortical vein thrombosis.






References



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2. Leach JL, Bulas RV, Ernst RJ, Cornelius RS. MR imaging of isolated cortical vein thrombosis: the hyperintense vein sign. J Neurovasc Dis 1996; 1:17.
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3. Derdeyn CP, Powers WJ. Isolated cortical venous thrombosis and ulcerative colitis. AJNR Am J Neuroradiol 1998;19:488490.
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4. Ahn TB, Roh JK. Cerebral venous thrombosis in adults: the role of imaging evaluation and management. Arch Neurol 2003; 60:1314 -1316.
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