Rationale: Isolated cortical venous thrombosis (ICoVT) is a rare type of cerebral venous thrombosis. Because of its atypical clinical presentation and imaging features that resemble those of brain tumors, ICoVT is often misdiagnosed as a brain tumor. Patient concerns: This study reports 2 patients with ICoVT. Both experienced a gradual onset of symptoms—one presented primarily with headache, whereas the other developed progressive limb weakness. Diagnoses and interventions: Brain magnetic resonance imaging revealed a large hemorrhagic lesion in 1 patient, showing ring enhancement and extensive surrounding edema. The other patient had an ischemic lesion with similar ring enhancement and marked perilesional edema. Outcomes: Given the suspicion of a brain tumor, both patients underwent surgical biopsy. Intraoperatively, cortical venous thrombosis was identified, and histopathological findings confirmed the diagnosis of ICoVT. Both patients subsequently received effective anticoagulant therapy. Lessons: ICoVT has atypical clinical and imaging characteristics and is easily mistaken for brain tumors. When neuroimaging demonstrates cortical hemorrhage or ischemic lesions accompanied by extensive edema, the possibility of ICoVT should be considered.
Cheng et al. (Fri,) studied this question.