68 Embolism is not a cause of sinus thrombosis, but the reverse might exist: fragmentation of clot in a thrombosed sinus, migration of the fragment along the jugular vein into the heart, and finally, paradoxically, into a (brain) artery. TIA-like episodes stopped with anticoagulation. The vein of Trolard is a large posterior frontal vein (usually in the post-central sulcus) draining into the superior sagittal sinus. Venous phase image of the right internal carotid artery shows a tubular filling defect within the superficial cortical vein of Trolard (arrow) and engorgement of the surrounding venules, suggestive of thrombosis of the vein of Trolard. Overview. Transverse sinus thrombosis in small preterm infants may be entirely asymptomatic. The vein of Trolard is an important cortical vein as it drains eloquent cortex. Vein of Trolard thrombosis Mo Yang 1, Sabrina Yum 2, Li Yang 1 1 Department of Neurology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China 2 Department of Neurology, Children's Hospital of Philadelphia, Philadelphia, Commonwealth of Pennsylvania, USA We report the case of a 28 year old postpartum lady who presented to us with headache. To our knowledge, there have been no cases of bilateral vein of Trolard thrombosis reported in literature. Occipital sinus was identified in 17(8.3%), vein of Trolard in 98(48.03%) and vein of Labbe in 105(51.47%). Isolated cortical vein thrombosis is a rare condition characterized by coagulopathy from different etiologies. Superior anastomotic vein (Trolard) connects the SSS and Superficial middle cerebral vein. Magnetic resonance imaging revealed acute thrombosis of the right superficial middle cerebral vein and the vein of Trolard. Venous thrombosis with absence of normal flow void on T1-weighted image. High signal abnormalities were not as apparent on standard T2 weignted images. Symptoms may include headache, abnormal vision, any of the symptoms of stroke such as weakness of the face and limbs on one side of the body, and seizures. Trolard, by the way, is just a name for a big parietal vein — superior, inferior parietal, whatever. (g, h) Posterosuperior (g) and lateral (h) 3D integral images from CT venography show thrombosis of the right superficial middle cerebral vein (short arrow) and of the anastomotic vein of Trolard (arrowhead) with extension to the superior sagittal sinus (long arrow in g) and swelling of the gyri. Isolated cortical vein thrombosis (ICVT) accounts for less than 1% of all cerebral infarctions. • Diagnosis is usually made using noninvasive venous imaging, seldom intraoperatively. F ig 1.. Di use pachymeningeal enhancement a er gadolinium administration (arrows), suggestive of liquoral hypotension. A, Axial FLAIR (10,002/158/2200) [TR/TE/TI] MR image shows focal sulcal hyperintensity at the right frontoparietal convexity (arrows).. B, Right parasagittal T1-weighted (500/14) MR image shows tubular hyperintense thrombus (arrows) in a right convexity cortical vein, probably the vein of Trolard. veins; Trolard vein [superior anastomotic vein] [4]; and anterior parietal veins [5]) and the larger named veins on the lateral surface of the cerebrum (the superficial sylvian vein [superficial middle cerebral vein] [6], which typically drains into the sphenoparietal sinus or the cavernous sinus, and the Labbe´ vein … Head trauma a few days earlier was the most likely mechanism of venous thrombosis. Case Reports in Neurological Medicine F : Brain MRI. We report the case of a 35 year-old woman who presented with numbness, weakness and seizures secondary to thrombosis of the superior anastomotic vein of Trolard, during the initial onset of nephrotic syndrome. After identification of the thrombus on T2*GE imaging, an occlusion of the Trolard vein and of the vein of Labbé was recognized on MRV, respectively, in patients 3 and 8. The vein of Labbe is part of the superficial cerebral venous system of the temporal lobe . The vein of Trolard is an important cortical vein as it drains eloquent cortex. Case report of isolated vein of trolard thrombosis in an HBsAg-positive patient By Sudhakar M Rao, Supriya Khardenavis, Anirudda Deshpande and Suresh Pandi No … To our knowledge, there have been no cases of bilateral vein of Trolard thrombosis reported in literature. Cortical vein thrombosis is usually secondary to retrograde extension of dural sinus thrombosis. Drain into the SSS. Cerebral venous thrombosis (CVT) is an uncommon cause of hemorrhagic stroke. Internal Group: Collect blood from the inner side of the brain. Noncontrast CT brain revealed bandlike high attenuation along the course of the left vein of Labbe (figure 1). Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Cortical Venous Thrombosis We report 2 cases of bilateral vein of Trolard thrombosis; one with and the other without dural sinus involvement. To our knowledge, there have been no cases of bilateral vein of Trolard thrombosis reported in literature. On evaluation, she was found to have an acute subarachnoid hemorrhage secondary to isolated thrombosis of the vein of Trolard. We report 2 cases of bilateral vein of Trolard thrombosis; one with and the other without dural sinus involvement. In this paper, we report a case of isolated right Labbe vein thrombosis after infliximab therapy for Crohn’s disease. Isolated right vein of Labbé thrombosis has only been described in a handful of cases. Inferior Group: Formed by the deep middle cerebral vein. In the ER, he experienced a generalised seizure. Patient 1, a 29-year-old woman with headaches, seizures, and cortical venous thrombosis. Isolated CVT without dural sinus involvement is very rare and presentation as sub arachnoid haemorrhage is even rarer. We report 2 cases of bilateral vein of Trolard thrombosis; one with and the other without dural sinus involvement. The central vein, precentral vein, a small frontal vein, and the midfrontal vein were involved respectively in patients 1, 2, 4, and 6. Venous Thrombosis.This occurs most often in the legs or pelvis; it may be a complication of phlebitis, result from injury to a vein, or occur with prolonged bed rest.The symptoms—a feeling of heaviness, pain, warmth, or swelling in the affected part, and sometimes chills and … The relative luminal diameters of the Trolard vein, Labbe´ vein, and superficial sylvian veins are reciprocal. A 66-year-old man with tongue carcinoma presented to the emergency room (ER) with decreased oral intake for one week. 1. A 10-year-old woman presented with seizure episodes. Normal variations in cerebral venous anatomy and their potential pitfalls on 2D TOF MRV examination: Results from a private tertiary care hospital in Karachi The vein of Trolard and other superior cerebral veins draining into the superior sagittal sinus were thrombosed in 10/12 patients, and the vein of Labbé was thrombosed in 4/12 patients. We report 2 cases of bilateral vein of Trolard thrombosis; one with and the other without dural sinus involvement. Isolated cortical venous thrombosis (ICVT) occurring in the absence of dural venous thrombosis, constitutes about 2%–5% of all cerebral venous thrombosis. Cerebral angiography. • Rare intraoperative photographs of an occlusive thrombus in the vein of Trolard are provided. Neurological examination was non-focal. Axial FLAIR images show obvious high signal abnormalities along the grey matter of the posterior right frontal lobe that extend toward the apex of the brain and the sagital sinus. For reasons unknown, thrombosis of the left vein of Labbé occurs significantly more frequently than the right. Its vague, non-specific presentation makes it a difficult and challenging diagnosis that needs an extensive workup especially in young patients. Download Citation | Bilateral Vein of Trolard Thrombosis | Isolated cortical vein thrombosis without dural sinus involvement is not common. Cerebral venous thrombosis (CVT) is a blood clot of a cerebral vein in the brain.This vein is responsible for draining blood from the brain. Developmental venous anomalies (DVAs) are the most commonly encountered cerebral malformations. Review of the literature reveals few cases of isolated thrombosis of either the inferior anastomotic vein of Labbe or vein of Trolard [1-11]. TIA of arterial origin was excluded by detailed investigations. The Rolando is a named vein, running by definition in the Rolandic sulcus, anterior to Trolard. To our knowledge, there have been no cases of bilateral vein of Trolard thrombosis reported in literature. Cerebral venous sinus thrombosis (CVST) is the presence of acute thrombosis (a blood clot) in the dural venous sinuses, which drain blood from the brain. The vein of Trolard is an important cortical vein as it drains eloquent cortex. Outcome and prognosis depend mainly on early diagnosis and treatment. ICVT may cause irreversible parenchymal damage, rendering early and accurate diagnosis critical. While generally asymptomatic and discovered as incidental findings, there is a small number that can cause intracranial haemorrhage, usually attributed to associated cavernomas; however, venous thrombosis of the draining vein is a rare cause. Deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) are more common among these patients, but cerebrovascular, mesenteric, portal and retinal veins can also be affected. The vein of Trolard is an important cortical vein as it drains eloquent cortex. It drains the lower surface of the hemisphere and the insula. The superior anastamotic veins (veins of Trolard) are the largest paired superficial veins draining to the superior sagittal sinus.The unenhanced CT in this case nicely demonstrates the cord sign of a hyperdense, expanded cerebral vein. cortical vein of Trolard (arrow) and engorgement of the surrounding venules, suggestive of thrombosis of the vein of Trolard.
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