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Cerebral Venous Thrombosis with Tumor-like Features: A Case Report and Review of the Literature.

Xu T, et al. World Neurosurg. 2019.


BACKGROUND: Cerebral venous thrombosis (CVT), a rare cerebrovascular condition, is induced by blocked cerebral venous reflux, often presenting non-specific symptoms. Magnetic resonance imaging (MRI) of the brain may improve the often elusive diagnosis of CVT. However, the sensitivity, specificity and full spectrum of such MRI findings are poorly understood.

CASE DESCRIPTION: We report the case of a 53-year-old male patient with CVT. The patient complained of a severe headache in addition to an enhanced lesion on contrasted T1-weighted MR images, which was originally considered an angiogenic tumor. However, surgery and pathology confirmed the case to be CVT. Following surgery and administration of an anticoagulation agent, the patient's symptoms alleviated, and cranial MRI and CT 1 month after surgery showed no abnormalities.

CONCLUSIONS: We conclude that such cases may occur where CVT appears tumor-like on MRI, including mass effect and abnormal contrast enhancement. Therefore, for young and middle-aged adults with episodic and progressive headaches presenting such MRI findings, the possibility of CVT should always be considered. MRI combined with magnetic resonance venography should be used as the preferred strategy for early diagnosis of CVT.

Copyright © 2018 Elsevier Inc. All rights reserved.


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