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Fig 8. Cortical vein thrombosis. This 16-year-old boy with acute lymphoblastic leukemia presented with emesis, headache, and impaired speech. On the postcontrast coronal T1-GRE image (A), there is a large irregular acute hemorrhage in the left parietal lobe with surrounding edema and adjacent sulcal effacement. Tubular filling defects are also visible on either side of the superior sagittal sinus (white arrows), consistent with thrombosed cortical veins. An axial FLAIR image (B) shows symmetric bilateral edema, adjacent to large hypointense cortical veins (black arrows) on SWI (C). In this case, the enlarged cortical veins were due to thrombosis, which was thought to be secondary to coagulopathy associated with PEG-asparaginase administration.
