[Thrombosis of cortical vein: a case report]

A 39-year-old woman presented with disturbed consciousness, left hemiparesis and headache. CT scan revealed subcortical hemorrhage in the right parietal region, which had lower density than usual intracerebral hemorrhage and was associated with irregular perifocal edema. Cerebral angiograms revealed narrowed cortical vein with irregular wall in the right parietal region, where delayed local blood flow into the deep cerebral veins through collateral vessels was noted. The diagnosis was subcortical hemorrhage due to thrombosis of cortical vein. Her symptoms and brain edema were progressive. To reduce intracranial pressure, evacuation of the hematoma was performed. The hematoma which existed 1cm under the right parietal cortex was about 20g in weight. She remarkably improved soon after operation. Frequency of sinovenous thrombosis has been reported to be about 10% of all cerebral ischemic diseases, however, localized venous thrombosis is rare among them. This is because it is not always symptomatic and it is difficult to make accurate diagnosis. Six cases of localized venous thrombosis were reviewed, in which accurate diagnosis were established by cerebral angiograms, CT scan and/or autopsy. Clinical and radiological features of this case were presented.