孤立皮层静脉血栓形成及病例分享.pptVIP

81 year-old man presented with stroke and right-side weakness.CT image (Fig 1) shows irregular hemorrhagic lesion separated into segments located temporo-occipital and probably with different age of occurrence.MR images (Fig 2) after Gd-administration shows pial enhancement in left temporo-occipital area and several prominent vascular structures consequently to confused venous drainage in temporo - occipital area.A sequence of internal carotid artery phlebograms demonstrates in early venous phase delayed local venous circulation with absence of temporo-occipital vein (Fig 3).The late venous phase (Fig 4) shows delayed appearance of the cortical vein with venous stasis (arrow). * Fig. 1 Fluid attenuated inversion recovery (FLAIR) showed cord sign and dot sign consistent with those of the superficial Sylvian vein. Axial sections (A), sagittal sections (C), and coronal sections (D). Echo-planar T2* susceptibility-weighted imaging also showed a restiform low-intensity lesion that coincided with the high-intensity lesion in FLAIR (B). * Fig 1. [A] Axial FLAIR (9000/2500/83) [TR/TE/TI] image shows linear sulcal hyperintensities in the parietal convexities (arrows). [B] Axial FLAIR (9000/2500/83) image showing hyperintensities also in cortical gyri of the parietal lobes (arrows). [C] Sagittal T1-weighted image (500/9,1) showing punctiform hyperintensity adjacent to the parietal lobe (arrow), suggesting thrombosis in a right cortical vein. [D] Sagittal T1-weighted image (500/9,1) with the same finding adjacent to the left parietal lobe (arrow). Fig 2. [A] MR Venography, sagittal view, maximum intensity projection (MIP) reconstruction, showing patency of the superior sagittal sinus (arrowheads). [B] MR Venography, oblique axial MIP reconstruction, showing both the right (arrow) and left (hollow arrow) hyperintense thrombosed cortical veins. thun Fig 3. Axial FLAIR (9000/2500/80) image, 10 days after the first examination, showing complete resolution of the findin