• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.199-205
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• 2022

Developmental venous anomalies (DVAs) are common intracranial vascular malformations and they are generally do not cause clinical complications. In cases showing DVA and hemorrhage, the hemorrhage is usually associated with adjacent cavernous malformations. Very few cases of intracerebral hemorrhage (ICH) caused by thrombosis in DVA have been reported in the literature. In this case report, we present an interesting case of a large ICH caused by thrombosis within a DVA with an unusual structure that may have potentiated the thrombosis.

• Journal of Korean Neurosurgical Society
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• v.64 no.3
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• pp.418-426
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• 2021

Objective : A role of diffusion-weighted imaging (DWI) in the diagnosis of cerebral venous thrombosis (CVT) is not well-understood. This study evaluates the effectiveness of DWI in the diagnosis of CVT. Methods : Literature search was conducted in electronic databases for the identification of studies which reported the outcomes of patients subjected to DWI for CVT diagnosis. Random-effects meta-analyses were performed to achieve overall estimates of important diagnostic efficiency indices including hyperintense signal rate, the sensitivity and specificity of DWI in diagnosing CVT, and the apparent diffusion coefficient (ADC) of DWI signal areas and surrounding tissue. Results : Nineteen studies (443 patients with 856 CVTs; age 40 years [95% confidence interval (CI), 33 to 43]; 28% males [95% CI, 18 to 38]; symptom onset to DWI time 4.6 days [95% CI, 2.3 to 6.9]) were included. Hyperintense signals on DWI were detected in 40% (95% CI, 26 to 55) of the cases. The sensitivity of DWI for detecting CVT was 22% (95% CI, 11 to 34) but specificity was 98% (95% CI, 95 to 100). ADC values were quite heterogenous in DWI signal areas. However, generally the ADC values were lower in DWI signal areas than in surrounding normal areas (mean difference-0.33×10-3 ㎟/s [95% CI, -0.44 to -0.23]; p<0.00001). Conclusion : DWI has a low sensitivity in detecting CVT and thus has a high risk of missing many CVT cases. However, because of its high specificity, it may have supporting and exploratory roles in CVT diagnosis.

• Pediatric Infection and Vaccine
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• v.26 no.3
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• pp.188-193
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• 2019

Since the implementation of conjugate Haemophilus influenzae serotype b (Hib) vaccine, the rate of infections caused by Hib has dramatically decreased, and the proportion of infections caused by non-type b H. influenzae has increased. Cerebral venous sinus thrombosis (CVST) is rare; however, it should be considered as a potential complication of bacterial meningitis. Herein, we report about a child who developed CVST after being diagnosed with H. influenzae serotype f meningitis.

• Journal of Korean Neurosurgical Society
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• v.58 no.2
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• pp.150-154
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• 2015

Cerebral venous sinus thrombosis (CVST) following a closed head injury in pediatric patients is a rare condition, and an early spontaneous recanalization of this condition is extremely rare. A 10-year-old boy was admitted with a mild, intermittent headache and nausea five days after a bicycle accident. The brain computed tomography showed an epidural hematoma at the right occipital area with pneumocephalus due to a fracture of the occipital skull bone. The brain magnetic resonance imaging and the magnetic resonance venography demonstrated a flow signal loss from the right sigmoid sinus to the right jugular vein. The diagnosis was sigmoid sinus thrombosis, so close observations were selected as a treatment for the patient because of his gradually improving symptoms; however, he complained of vomiting 14 days the after conservative treatment. The patient was readmitted for a further examination of his symptoms. The laboratory and the gastroenterological examinations were normal. Due to concern regarding the worsening of the sigmoid sinus thrombosis, the brain magnetic resonance venography was rechecked and it revealed the recanalization of the venous flow in the sigmoid sinus and in the jugular vein.

• Tuberculosis and Respiratory Diseases
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• v.77 no.6
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• pp.274-278
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• 2014

Antiphospholipid syndrome (APS) is an acquired systemic autoimmune disorder characterized by a combination of clinical criteria, including vascular thrombosis or pregnancy morbidity and elevated antiphospholipid antibody titers. It is one of the causes of deep vein thrombosis and pulmonary embolism that can be critical due to the mortality risk. Overall recurrence of thromboembolism is very low with adequate anticoagulation prophylaxis. The most effective treatment to prevent recurrent thrombosis is long-term anticoagulation. We report on a 17-year-old male with APS, who manifested blue toe syndrome, deep vein thrombosis, pulmonary thromboembolism, and cerebral infarction despite adequate long-term anticoagulation therapy.

• Journal of Korean Neurosurgical Society
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• v.48 no.4
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• pp.357-359
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• 2010

While a delayed intracerebral hemorrhage at the site of a ventricular catheter has occasionally been reported in literature, a delayed hemorrhage caused by venous infarction secondary to ventriculoperitoneal shunting has not been previously reported. In the present case, a 68-year-old woman underwent ventriculoperitoneal shunting through a frontal burr hole, and developed a hemorrhagic transformation of venous infarction on the second postoperative day. This massive venous infarction was caused by bipolar coagulation and occlusion of a large paramedian cortical vein in association with atresia of the rostral superior sagittal sinus. Thus, to eliminate the risk of postoperative venous infarction, technical precautions to avoid damaging surface vessels in a burr hole are required under loupe magnification in ventriculoperitoneal shunting.

• Journal of Korean Neurosurgical Society
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• v.43 no.1
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• pp.48-50
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• 2008

We experienced a case of giant arachnoid granulation misdiagnosed as dural sinus thrombosis. A 66-year-old woman presented with a one month history of progressive occipital headache. Computed tomography angiography and cerebral angiography showed a round filling defect at the transverse sinus which was speculated as a transverse sinus thrombosis. Anticoagulation therapy was performed to prevent worsening of thrombosis for 2 weeks and then a Gadolinium-enhanced magnetic resonance imaging scan was performed. The filling defect lesion at the transverse sinus revealed a non-enhancing granule with central linear enhancement, which was compatible with giant arachnoid granulation. We checked the intrasinus pressure difference across the lesion the through the dural sinus in order to exclude the lesion as the cause of headache. Normal venous pressure with no significant differential pressure across the lesion was noted. Headache was treated with medical therapy.

• Journal of Korean Neurosurgical Society
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• v.54 no.1
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• pp.47-49
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• 2013

As a rare cerebrovascular disease, cerebral venous thrombosis (CVT) is caused by various conditions including trauma, infection, oral contraceptive, cancer and hematologic disorders. However, iron deficiency anemia is not a common cause for CVT in adult. Posterior fossa infarction following CVT is not well demonstrated because posterior fossa has abundant collateral vessels. Here, we report a case of a 55-year-old man who was admitted with complaints of headache, nausea, and mild dizziness. The patient was diagnosed with isolated lateral sinus thrombosis presenting as cerebellar infarction. Laboratory findings revealed normocytic normochromic anemia due to iron deficiency, and the patient's symptoms were improved after iron supplementation.

• Journal of the Korean Society of Radiology
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• v.83 no.5
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• pp.1147-1152
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• 2022

Presumed idiopathic intracranial hypertension (IIH) is a disorder of elevated intracranial pressure with unknown etiology, and 10% of cases occur secondarily to cerebral venous sinus thrombosis (CVST). CVST may be underestimated when findings of IIH are missed in a normal-weight patient without risk factors of coagulopathy. Here, we present a case of CVST that mimics a neurogenic tumor in the hypoglossal canal in a normal-weight patient without risk factors of coagulopathy.

• Journal of Korean Neurosurgical Society
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• v.66 no.6
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• pp.735-742
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• 2023

Nephrotic syndrome (NS) is associated with cerebral venous sinus thrombosis (CVST), which is a rare cerebrovascular disorder in children. Systemic anticoagulation with heparin is the standard therapy for CVST, and mechanical thrombectomy (MT) has been described as a salvage treatment for adult anticoagulant refractory CVST, However, it has never been reported in children. We describe a case of MT for refractory CVST in a child with NS. A 13-year-old boy with newly diagnosed NS presented to an emergency department with acute headache. A head computed tomography showed acute thrombus in the superior sagittal sinus, straight sinus and transverse sinus. The child was started on heparin therapy, but clinically deteriorated and became unresponsive. In view of the rapid deterioration of the condition after anticoagulation treatment, the patient received intravascular treatment. Several endovascular technologies, such as stent retriever and large bore suction catheter have been adopted. After endovascular treatment, the patient's neurological condition was improved within 24 hours, and magnetic resonance venography of the head demonstrated that the CVST was reduced. The child recovered with normal neurological function at discharge. This case highlights the importance of considering MT for refractory CVST, and we suggest that MT may be considered for refractory CVST with NS in children.