PT  - JOURNAL ARTICLE
AU  - Röttger, Carina
AU  - Trittmacher, Susan
AU  - Gerriets, Tibo
AU  - Blaes, Franz
AU  - Kaps, Manfred
AU  - Stolz, Erwin
TI  - Reversible MR Imaging Abnormalities following Cerebral Venous Thrombosis
DP  - 2005 Mar 01
TA  - American Journal of Neuroradiology
PG  - 607--613
VI  - 26
IP  - 3
4099  - http://www.ajnr.org/content/26/3/607.short
4100  - http://www.ajnr.org/content/26/3/607.full
SO  - Am. J. Neuroradiol.2005 Mar 01; 26
AB  - BACKGROUND AND PURPOSE: Although rare, cerebral venous thrombosis (CVT) is being diagnosed more frequently owing to improved imaging techniques. The venous infarcts caused by CVT in 50% of patients are largely reversible and differ from arterial stroke. Our purpose was to study the time-dependent changes of venous infarcts on MR images and to define the variables that influence lesion volume in humans.METHODS: MR images and venous angiograms were evaluated in 15 consecutive patients with venous infarcts due to CVT of sinus, cortical, or internal veins. All patients were treated with intravenous dose-adjusted heparin followed by oral anticoagulation for 12 months. Reduction of signal intensity changes on T1- and T2-weighted images was correlated to the degree of recanalization, age, initial absolute lesion size, and hemorrhage.RESULTS: Within the first 30 days, we found a significant correlation between the volume of the lesion on T1-weighted images and recanalization. However, early recanalization did not influence the final lesion volume after 12 months. Eleven patients showed complete resolution of changes on T1- and T2-weighted images. Age of the patients influenced initial absolute volume of brain damage.CONCLUSION: In venous stroke, even large parenchymal changes can resolve completely independent from recanalization of the thrombosed veins and sinuses. A plausible hypothesis is that venous infarcts largely consist of a persistent edema and that the lesion volume is influenced by the development of collateral veins. However, further investigations are necessary to understand the underlying abnormal mechanisms.