Cryptogenic Isolated Cortical Venous Infarct: A Report of Three Cases

Abstract

Cortical vein infarction without dural sinus involvement is extremely rare. Herein, we present three patients with headache, partial seizure and rightsided numbness. On neurological examination, focal neurologic deficit was not observed in our patients. Magnetic resonance imaging revealed cerebral ischemia which showed as hypointense on T1-weighted images and hyperintense on T2-weighted images that do not follow the boundary of arterial territories, indicating cortical venous infarct. Cortical venous infarct should be suspected in patients who present with sudden onset headache and/or focal epileptic seizures even if there is no neurologic deficit. The diagnosis and treatment of cortical venous infarct should be considered as an emergency because of the high potential for full recovery with anticoagulant treatment.

Keywords

• Cortical venous infarct, seizure, anticoagulant treatment

References

1. Garten RJ, Davis CT, Russell CA, Shu B, Lindstrom S, Balish A, et al. Antigenic and genetic characteristics of swine-origin 2009 A(H1N1) influenza viruses circulating in humans. Science 2009;325:197-201. [CrossRef]
2. Outbreak of swine-origin influenza A (H1N1) virus infection - Mexico, March-April 2009. MMWR Morb Mortal Wkly Rep 2009;58:467-70.
3. Kumar A, Zarychanski R, Pinto R, Cook DJ, Marshall J, Lacroix J, et al. Critically Ill Patients With 2009 Influenza A(H1N1) Infection in Canada. JAMA 2009;302:1872-9. [CrossRef]
4. Gordon SM. Update on 2009 pandemic influenza A (H1N1) virus Cleveland Clinic Journal Of Medicine 2009;76:577-82. [CrossRef]
5. Agarwal PP, Cinti S, Kazerooni EA. Chest radiographic and CT findings in novel swine-origin influenza A (H1N1) virus (S-OIV) in- fection. Am J Roentgenol 2009;193:1488-93. [CrossRef]
6. Dawood FS, Jain S, Finelli L, Shaw MW, Lindstrom S, Garten RJ, et al. Emergence of a novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med 2009;360:2605-15. [CrossRef]
7. Louie JK, Acosta M, Winter K, Jean C, Schecter R, Vugia D, et al. Factors associated with death or hospitalization due to pan- demic 2009 influenza A (H1N1) infection in California. JAMA 2009;302:1896-902. [CrossRef]
8. Perez-Padilla R, de la Rosa-Zamboni D, Ponce de Leon S, Her- nandez M, Quiñones-Falconi F, Bautista E, et al. Pneumonia and respiratory failure for swine-origin influenza A(H1N1) in Mexico.N Engl J Med 2009;361:680-9. [CrossRef]

9. Hospitalized patients with novel influenza A (H1N1) virus infec- tion - California, April-May, 2009. MMWR Morb Mortal Wkly Rep 2009;58:536-41.
10. Jain S, Kamimoto L, Bramley AM, Schmitz AM, Benoit SR, Louie J, et al. Hospitalized patients with 2009 H1N1 influenza in the United States, N Engl J Med 2009;361:1935-44. [CrossRef]
11. Cunha BA, Pherez FM, Schoch P. Diagnostic importance of rela- tive lymphopenia as a marker of swine influenza (H1N1) in adults. Clin Infect Dis 2009;49:1454-6. [CrossRef]
12. Perez-Padilla R, de la Rosa-Zamboni D, Ponce de Leon S, Hernan- dez M, Quiñones-Falconi F, Bautista E, et al. Pneumonia and Re- spiratory Failure from Swine-Origin Influenza A (H1N1) in Mexico. N Engl J Med 2009;361:680-9. [CrossRef]
13. Ohrui T, Takahashi H, Ebihara S, Matsui T, Nakayama K, Sasaki H, et al. Influenza A virus infection and pulmonary microthrombo- embolism. J Exp Med 2000;192:81-6.
14. Abdel-Ghafar AN, Chotpitayasunohdh T, Gao Z, Hayden FG, Nguyen DH, de Jong MD, et al. Update on avian influenza A (H5N1) virus infection in humans. N Engl J Med 2008;358:261-73. [CrossRef]
15. Van Wissen M, Keller TT, Ronkes B, Gerdes VE, Zaaijer HL, van Gorp EC, et al. Influenza infection and risk of acute pulmonary embolism. Thromb J 2007;5:16. [CrossRef]
16. Donaldson LJ, Rutter PD, Ellis BM, Greaves FE, Mytton OT, Pe- body RG, et al. Mortality from pandemic A/H1N1 2009 influenza in England: public health surveillance study. BMJ 2009;339:b5213. [CrossRef]
17. Louie JK, Acosta M, Winter K, Jean C, Gavali S, Schechter R, et al. Factors associated with death or hospitalization due to pandemic 2009 influenza A (H1N1) infection in California. JAMA 2009;302:1896. [CrossRef]
18. Rello J, Rodríguez A, Ibañez P, Socias L, Cebrian J, Marques A, et al. Intensive care adult patients with severe respiratory failure caused by influenza A (H1N1)v in Spain. Crit Care 2009;13:R148. [CrossRef]
19. Ginocchio CC, Zhang F, Manji R, Arora S, Bornfreund M, Falk L, et al. Evaluation of multiple test methods for the detection of the novel 2009 influenza A (H1N1) during the New York City outbreak. J Clin Virol 2009;45:191-5. [CrossRef]
20. Lee N, Chan PKS, Hui DS, Rainer TH, Wong E, Choi KW, et al. Viral loads and duration of viral shedding in adult patients hospi- talized with influenza. J Infect Dis 2009; 200:492-500. [CrossRef]