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Updated: Jul 11, 2026
09:59
A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
Published on: September 16, 2017
Pathogenesis of venous stroke: evaluation with diffusion- and perfusion-weighted MRI
Smitha Makkat1, Tadeusz Stadnik, Els Peeters
1Department of Radiology, University Hospital, Vrije Universiteit Brussel, Brussels, Belgium. Smitha.Makkat@vub.ac.be
Summary
This study suggests vasogenic edema is the initial event in venous stroke pathogenesis, potentially followed by cytotoxic edema. Diffusion- and perfusion-weighted MRI findings support this mechanism, aiding in understanding cerebral venous thrombosis.
Area of Science:
- Neurology
- Radiology
- Pathophysiology
Background:
- Diffusion- and perfusion-weighted MRI are valuable for diagnosing cerebral venous thrombosis.
- Conflicting theories exist regarding the pathophysiologic mechanisms of venous stroke, specifically the roles of vasogenic and cytotoxic edema.
Purpose of the Study:
- To review the pathogenesis of cerebral venous thrombosis using MRI findings.
- To present cases illustrating the proposed pathophysiologic mechanism.
Main Methods:
- Review of existing literature on cerebral venous thrombosis and MRI.
- Case report of two patients with cerebral venous infarction treated with heparin.
- Analysis of diffusion-weighted and perfusion-weighted MRI findings in the reported cases.
Main Results:
- The two reported cases showed MRI findings consistent with vasogenic edema and viable brain tissue.
- Symptoms and signs in these patients resolved following intravenous heparin therapy.
- Both patients recovered without significant long-term neurological deficits.
Conclusions:
- The findings support the hypothesis that vasogenic edema is the initial pathophysiologic event in venous stroke.
- Cytotoxic edema may subsequently develop, potentially leading to infarction.
- MRI plays a crucial role in evaluating the evolving mechanisms of cerebral venous thrombosis.
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