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Cerebral Venous Infarctions Presenting as Enhancing Space‐Occupying Lesions: MRI Findings
Author(s) -
Bakshi Rohit,
Lindsay Bret D.,
Bates Vernice E.,
Kinkel Peter R.,
Mechtler Laszlo L.,
Kinkel William R.
Publication year - 1998
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon199884210
Subject(s) - medicine , radiology , magnetic resonance imaging , biopsy , differential diagnosis , venous thrombosis , thrombosis , pathology , surgery
Cerebral venous thrombosis is an unusual form of cerebrovascular disease that may cause cerebral venous infarction (CVI). Magnetic resonance imaging (MRI) of the brain may improve the often elusive diagnosis of CVI. However, the sensitivity, specificity, and full spectrum of such MRI findings are poorly understood. The authors present the cases of three patients with CVI whose MRI scans showed abnormally enhancing tumor‐like brain lesions. Two of the CVIs were hemorrhagic and exerted mass effect. One patient showed increasingly nodular and heterogeneous ring‐like enhancement progressing from the single‐dose to the triple‐dose gadolinium contrast images. The CVI of a second patient also showed ring‐like enhancement. Biopsy was performed on one of these patients and was strongly considered for the other two patients to exclude neoplastic disease. Careful examination of the MRI appearance of venous structures and the use of specialized MRI techniques improved the recognition of CVI for two patients and prevented biopsy. This represents the first description of abnormal tripledose MRI contrast enhancement in CVI. Consideration of CVI in the care of patients with enhancing tumor‐like masses may lead to earlier diagnosis and treatment, preventing unnecessary invasive diagnostic procedures. CVI should be added to the differential diagnosis of supratentorial ring‐enhancing masses.