A case of cortical vein thrombosis with the cord sign

Arch Neurol. 2003 Sep;60(9):1314-6. doi: 10.1001/archneur.60.9.1314.


Background: Computed tomography is performed in suspicious cases of cerebral venous thrombosis. Although an empty delta sign is not uncommonly reported, a cord sign is rarely reported. But this is, if present, pathognomonic, especially in the case of cortical vein thrombosis.

Case description: A young man with antithrombin III deficiency sought emergency treatment for headache and seizure. Noncontrast computed tomography showed a typical cord sign in multiple sections. It seemed to be independent from the adjacent pathologic findings in most sections. Brain magnetic resonance imaging verified it as a thrombosed vein in conjunction with acute venous infarction.

Conclusion: The cord sign should be considered for early and accurate diagnosis of cortical vein thrombosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antithrombin III Deficiency / complications
  • Cerebral Cortex / blood supply*
  • Cerebral Veins / diagnostic imaging*
  • Cerebral Veins / pathology*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Radiography
  • Severity of Illness Index
  • Venous Thrombosis / diagnosis*
  • Venous Thrombosis / etiology