Isolated cortical vein thrombosis in a young male adult

BMJ Case Rep. 2021 Jun 15;14(6):e239988. doi: 10.1136/bcr-2020-239988.

Abstract

Isolated cortical vein thrombosis (ICVT) is a rare entity and accounts for only 6.3% of cerebral venous and sinus thrombosis. ICVT is an uncommon cause of seizures in young adults. We present a 27-year-old man with no medical history who presented with dizziness, loss of consciousness and a seizure-like episode. The patient was found to have an elevated D-dimer and brain imaging revealed ICVT. The patient was started on anticoagulation and antiseizure medications. A high index of suspicion for uncommon aetiologies for new-onset seizure, especially in the young, is key to accurate diagnosis of ICVT. Evaluation and work-up should include detailed physical examination, along with appropriate brain imaging and testing for other conditions that predispose venous thrombosis. In the setting of the SARS-CoV-2 pandemic, testing for COVID-19 may also be warranted. Rapid diagnosis and full anticoagulation can help avoid debilitating complications and long-term sequelae.

Keywords: epilepsy and seizures; neuroimaging; radiology.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • COVID-19 Testing
  • COVID-19*
  • Cerebral Veins* / diagnostic imaging
  • Humans
  • Intracranial Thrombosis* / diagnostic imaging
  • Intracranial Thrombosis* / drug therapy
  • Male
  • SARS-CoV-2
  • Venous Thrombosis* / diagnostic imaging
  • Venous Thrombosis* / drug therapy
  • Young Adult