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Cortical vein thrombosis as a possible mimic of cortical superficial siderosis (MRI)

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MRI in a 27-year-old woman with right-sided headache and sensory Jacksonian seizures demonstrates a hyperintense cortical lesion in the right postcentral parietal area on (a) axial T2-weighted and (b) axial FLAIR images (arrow), with (c) signal loss and “blooming” of the central vein on axial T2*-weighted image (arrow) without cortical superficial siderosis. (d,e) Circumscribed peripheral contrast enhancement in an axial post-contrast T1-weighted image (arrow) and (f) restricted diffusion of the thrombus on axial diffusion-weighted imaging. (Source: Weidauer S, Neuhaus E, Hattingen E. Cerebral superficial siderosis: etiology, neuroradiological features and clinical findings. Clin Neuroradiol 2023;33[2]:293-306. Creative Commons Attribution 4.0 International [CC BY 4.0] license, creativecommons.org/licenses/by/4.0.)