PMC9772549_01
Pathological neuroimaging studies per case showed evidence of venous infarction secondary to cortical venous thrombosis (CVT). (A) Initial stage computed tomography (CT) showed hypodensity with some hyperdensity in the right frontal-parietal lobes. (Ba) Magnetic resonance imaging (MRI) showed low-intensity signals mixed with high-intensity signals on T1-weighted images and high-intensity signals mixed with low-intensity signals on T2-weighted images in the right frontal-parietal lobes. (Bb) Contrast-enhanced MRI revealed focal circular heterogeneous enhancement of the lesion. (Ca) Magnetic resonance venography (MRV) showed cortical veins, and the corresponding parts of the superior sagittal sinus were sporadically visualized, which indicated CVI. (Cb) Magnetic resonance angiography (MRA) showed that the main arteries and their branches were normal. (D) Progressive CT showed expanded edema and a significant shift in the midline. (Ea,b) Histopathologic analysis revealed dilated small veins with congestion or thrombosis (blue arrow), while normal arterial structure and lumen (black arrow) and focal necrosis and inflammatory infiltration (green arrow) were found. (Ec) CT showed that part of the necrotic tissue was removed 24 h post-operatively. (Ed) Three-month follow-up post-operatively. (Fa) A case of glioblastoma was confirmed by pathology. (Fb) Imaging characters in a case of middle cerebral artery infarction.
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F1
Non-enhanced computed tomography (NECT) revealed hypodense lesions, which enclosed hyperdense lesions, in the right frontal-parietal lobes (Figure 1A). Hemorrhagic infarction was suspected, but glioma could not be excluded (Figure 1Ba). Subsequently, magnetic resonance angiography (MRA) showed that the main arteries and their branches were normal; therefore, arterial cerebral infarction was excluded (Figure 1Cb). Magnetic resonance venography (MRV) showed cortical veins, and the corresponding parts of the superior sagittal sinus were sporadically visualized, which indicated CVI (Figure 1Ca). Furthermore, contrast-enhanced MRI revealed focal circular heterogeneous enhancement of the lesion, which suggested glioma hemorrhage, but cerebral infarction could not be ruled out (Figure 1Bb). Emergency computed tomography (CT) showed expanded edema and a significant shift in the midline, possibly leading to the development of a hernia (Figure 1D). Histopathological results were consistent with cerebral infarction: gliosis with inflammatory exudation, necrosis, vasodilation, and thrombosis (Figure 1Ea,b). Post-operatively, necrotic tissue was removed (Figure 1Ec) the patient was administered low-molecular-weight heparin. The left thumb showed numbness and slight weakness at the 3- (Figure 1Ed) and 6-month follow-ups, but no neurological symptoms were observed.