Cerebral Venous Thrombosis Presenting as Simultaneous Intracerebral Hemorrhage

Acta Neurol Taiwan. 2024 Dec 30;33(4):206-207.ABSTRACTA 37-year-old pregnant woman presented to the emergency department with central facial palsy, ipsilateral right hemiparesis, and seizures. Brain Computed Tomogram (CT) showed intracerebral hemorrhage (ICH) and bilateral frontal edema. Magnetic resonance imaging (MRI) revealed multifocal hemorrhages consistent with a diagnosis of multiple simultaneous ICH (MSICH) (Figure 1). We suspected cerebral venous thrombosis (CVT) and performed a MR angiogram confirming this diagnosis (Figure 2). Upon admission, the patient was treated with low-molecular-weight heparin and transitioned to direct oral anticoagulation at discharge. Non traumatic MSICH is a rare imaging finding with high mortality, usually arterial in origin (1). However, since treatment options vary, cerebral venous thrombosis should always be considered in the differential diagnosis, especially in young female patients with known risk factors, such as pregnancy and puerperium (2-4). MRI modalities (Echo-GRE) are valuable tools in identifying ICH when CT is inconclusive (5).PMID:38073163

Source: Acta Neurologica Taiwanica - December 11, 2023 Category: Neurology Authors: Amado Jim énez-Ruiz Victor Aguilar-Fuentes Fernando Benavides-G ómez Jos é Luis Ruiz-Sandoval Source Type: research