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Isolated cortical vein thrombosis associated with prothrombin gene mutation
Elias A Giraldo1, Rohan Arora2, Robert A Koenigsberg1
1Department of Neurology, Drexel University College of Medicine, Philadelphia, Pennsylvania.
Summary
Isolated cortical vein thrombosis (ICVT) is rare. This case report details a frontal hemorrhage caused by isolated thrombosis of the vein of Labbe, linked to a prothrombin gene mutation.
Area of Science:
- Neurology
- Vascular Medicine
Background:
- Isolated cortical vein thrombosis (ICVT) is an uncommon cause of stroke, representing less than 1% of all stroke cases.
- Understanding the underlying risk factors and specific venous territories affected in ICVT is crucial for diagnosis and management.
Observation:
- A 47-year-old female presented with frontal hemorrhage, headache, and contralateral hemiparesis/hemisensory deficits.
- Catheter angiography revealed isolated thrombosis of the vein of Labbe, a nonarterial territory stroke, with no involvement of superficial middle cerebral veins.
Findings:
- The patient had a history of cardiovascular disease, stroke, factor V Leiden mutation, and smoking.
- Genetic testing identified a heterozygous prothrombin G20210 A gene mutation, establishing a prothrombotic state.
Implications:
- This case represents the first reported association between isolated cortical vein thrombosis and a prothrombin gene mutation.
- Highlights the importance of comprehensive thrombophilia screening in patients with unusual stroke presentations like ICVT.
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