A 38-year-old patient with partial seizures Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

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A 38-year-old patient with partial seizures Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology

A 38-year-old woman using hormonal contraception presented with right-sided abdominal and arm clonic seizures, right hemiparesis, hypesthesia, and nausea. She denied headache D-Dimers were 350 ng/ml (lab reference ≤500 ng/ml) CT showed a small left parietal hemorrhagic infarct with adjacent hyperdense cortical vein (figure 1). MRI 15 hours after onset showed magnetic susceptibility effect on susceptibility weighted imaging (SWI, figure 2) Pikija et al. © 2014 American Academy of Neurology Vignette

Pikija et al. © 2014 American Academy of Neurology Imaging

Pikija et al. © 2014 American Academy of Neurology Imaging

Magnetic Resonance Susceptibility Effect for Acute Isolated Cortical Vein Thrombosis Isolated cortical vein thrombosis is present in 5% of patients with cerebral venous thrombosis (CVT) 1 Negative D-Dimer and absence of headache does not exclude CVT 1 and SWI is useful for confirmation of the diagnosis 2 Pikija et al. © 2014 American Academy of Neurology