Subcortical hemorrhage: Marker for radiographically occult cerebral vein thrombosis on ct

Mark D. Keiper, Samuel E. Samuel, Scott W. Atlas, Robert I. Grossman

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Objective: Cerebral vein thrombosis (CVT) is a potentially life-threatening entity with a protean clinical presentation that can lead to delays in diagnosis and treatment. Computed tomography of the brain is often the initial imaging tool in evaluation of these patients, but is frequently nondiagnostic. This study identifies subcortical hemorrhage (SCH) as an indicator of radiographically occult CVT on CT. Materials and Methods: A retrospective analysis of all subjects (n = 24) with CVT proven by MRI over a 4 year period was performed. The CT examinations of all subjects were evaluated for the presence of SCH and signs of CVT. An evaluation of the correlation between findings on CT and MRI as well as the delay in diagnosis and treatment secondary to unrecognized CVT on CT was also performed. Results: Subcortical hemorrhage was noted in 9 of 24 (38%) subjects with CVT by MRI. The CT antedated MRI in eight of these subjects as the initial evaluation for presenting neurological symptoms. Subcortical hemorrhage was noted in six of eight of these subjects as the sole CT finding. Subcortical hemorrhage as well as CVT was seen in one subject, and no abnormality was seen in the final subject. Cerebral vein thrombosis was not suggested as a diagnosis in any of the six subjects with SCH as the sole radiographic finding. In all six of these cases, a delay in diagnosis occurred pending MRI obtained subsequently secondary to clinical deterioration. Conclusion: Subcortical hemorrhage can be seen in association with acute CVT and can be the sole abnormality on head CT. SCH as an isolated finding on CT suggests the possibility of unrecognized CVT, warranting further investigation by MRI.

Original languageEnglish (US)
Pages (from-to)527-531
Number of pages5
JournalJournal of Computer Assisted Tomography
Volume19
Issue number4
DOIs
StatePublished - Jan 1 1995

Fingerprint

Cerebral Veins
Intracranial Thrombosis
Hemorrhage
Head
Tomography

Keywords

  • Brain, hemorrhage
  • Brain, infarction
  • Computed tomography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Subcortical hemorrhage : Marker for radiographically occult cerebral vein thrombosis on ct. / Keiper, Mark D.; Samuel, Samuel E.; Atlas, Scott W.; Grossman, Robert I.

In: Journal of Computer Assisted Tomography, Vol. 19, No. 4, 01.01.1995, p. 527-531.

Research output: Contribution to journalArticle

Keiper, Mark D. ; Samuel, Samuel E. ; Atlas, Scott W. ; Grossman, Robert I. / Subcortical hemorrhage : Marker for radiographically occult cerebral vein thrombosis on ct. In: Journal of Computer Assisted Tomography. 1995 ; Vol. 19, No. 4. pp. 527-531.
@article{7b94f2f55cc34e6c80af74f041ca411f,
title = "Subcortical hemorrhage: Marker for radiographically occult cerebral vein thrombosis on ct",
abstract = "Objective: Cerebral vein thrombosis (CVT) is a potentially life-threatening entity with a protean clinical presentation that can lead to delays in diagnosis and treatment. Computed tomography of the brain is often the initial imaging tool in evaluation of these patients, but is frequently nondiagnostic. This study identifies subcortical hemorrhage (SCH) as an indicator of radiographically occult CVT on CT. Materials and Methods: A retrospective analysis of all subjects (n = 24) with CVT proven by MRI over a 4 year period was performed. The CT examinations of all subjects were evaluated for the presence of SCH and signs of CVT. An evaluation of the correlation between findings on CT and MRI as well as the delay in diagnosis and treatment secondary to unrecognized CVT on CT was also performed. Results: Subcortical hemorrhage was noted in 9 of 24 (38{\%}) subjects with CVT by MRI. The CT antedated MRI in eight of these subjects as the initial evaluation for presenting neurological symptoms. Subcortical hemorrhage was noted in six of eight of these subjects as the sole CT finding. Subcortical hemorrhage as well as CVT was seen in one subject, and no abnormality was seen in the final subject. Cerebral vein thrombosis was not suggested as a diagnosis in any of the six subjects with SCH as the sole radiographic finding. In all six of these cases, a delay in diagnosis occurred pending MRI obtained subsequently secondary to clinical deterioration. Conclusion: Subcortical hemorrhage can be seen in association with acute CVT and can be the sole abnormality on head CT. SCH as an isolated finding on CT suggests the possibility of unrecognized CVT, warranting further investigation by MRI.",
keywords = "Brain, hemorrhage, Brain, infarction, Computed tomography",
author = "Keiper, {Mark D.} and Samuel, {Samuel E.} and Atlas, {Scott W.} and Grossman, {Robert I.}",
year = "1995",
month = "1",
day = "1",
doi = "10.1097/00004728-199507000-00003",
language = "English (US)",
volume = "19",
pages = "527--531",
journal = "Journal of Computer Assisted Tomography",
issn = "0363-8715",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Subcortical hemorrhage

T2 - Marker for radiographically occult cerebral vein thrombosis on ct

AU - Keiper, Mark D.

AU - Samuel, Samuel E.

AU - Atlas, Scott W.

AU - Grossman, Robert I.

PY - 1995/1/1

Y1 - 1995/1/1

N2 - Objective: Cerebral vein thrombosis (CVT) is a potentially life-threatening entity with a protean clinical presentation that can lead to delays in diagnosis and treatment. Computed tomography of the brain is often the initial imaging tool in evaluation of these patients, but is frequently nondiagnostic. This study identifies subcortical hemorrhage (SCH) as an indicator of radiographically occult CVT on CT. Materials and Methods: A retrospective analysis of all subjects (n = 24) with CVT proven by MRI over a 4 year period was performed. The CT examinations of all subjects were evaluated for the presence of SCH and signs of CVT. An evaluation of the correlation between findings on CT and MRI as well as the delay in diagnosis and treatment secondary to unrecognized CVT on CT was also performed. Results: Subcortical hemorrhage was noted in 9 of 24 (38%) subjects with CVT by MRI. The CT antedated MRI in eight of these subjects as the initial evaluation for presenting neurological symptoms. Subcortical hemorrhage was noted in six of eight of these subjects as the sole CT finding. Subcortical hemorrhage as well as CVT was seen in one subject, and no abnormality was seen in the final subject. Cerebral vein thrombosis was not suggested as a diagnosis in any of the six subjects with SCH as the sole radiographic finding. In all six of these cases, a delay in diagnosis occurred pending MRI obtained subsequently secondary to clinical deterioration. Conclusion: Subcortical hemorrhage can be seen in association with acute CVT and can be the sole abnormality on head CT. SCH as an isolated finding on CT suggests the possibility of unrecognized CVT, warranting further investigation by MRI.

AB - Objective: Cerebral vein thrombosis (CVT) is a potentially life-threatening entity with a protean clinical presentation that can lead to delays in diagnosis and treatment. Computed tomography of the brain is often the initial imaging tool in evaluation of these patients, but is frequently nondiagnostic. This study identifies subcortical hemorrhage (SCH) as an indicator of radiographically occult CVT on CT. Materials and Methods: A retrospective analysis of all subjects (n = 24) with CVT proven by MRI over a 4 year period was performed. The CT examinations of all subjects were evaluated for the presence of SCH and signs of CVT. An evaluation of the correlation between findings on CT and MRI as well as the delay in diagnosis and treatment secondary to unrecognized CVT on CT was also performed. Results: Subcortical hemorrhage was noted in 9 of 24 (38%) subjects with CVT by MRI. The CT antedated MRI in eight of these subjects as the initial evaluation for presenting neurological symptoms. Subcortical hemorrhage was noted in six of eight of these subjects as the sole CT finding. Subcortical hemorrhage as well as CVT was seen in one subject, and no abnormality was seen in the final subject. Cerebral vein thrombosis was not suggested as a diagnosis in any of the six subjects with SCH as the sole radiographic finding. In all six of these cases, a delay in diagnosis occurred pending MRI obtained subsequently secondary to clinical deterioration. Conclusion: Subcortical hemorrhage can be seen in association with acute CVT and can be the sole abnormality on head CT. SCH as an isolated finding on CT suggests the possibility of unrecognized CVT, warranting further investigation by MRI.

KW - Brain, hemorrhage

KW - Brain, infarction

KW - Computed tomography

UR - http://www.scopus.com/inward/record.url?scp=0029166674&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029166674&partnerID=8YFLogxK

U2 - 10.1097/00004728-199507000-00003

DO - 10.1097/00004728-199507000-00003

M3 - Article

C2 - 7622677

AN - SCOPUS:0029166674

VL - 19

SP - 527

EP - 531

JO - Journal of Computer Assisted Tomography

JF - Journal of Computer Assisted Tomography

SN - 0363-8715

IS - 4

ER -