Unilateral thalamic edema in internal cerebral venous thrombosis: Is it mostly left?

Thrombotic occlusion of the internal cerebral veins is a particularly dange rous form of cerebral venous thrombosis (CVT) as it causes venous infarctio n of the thalami. Because both thalami drain into the vein of Galen and str aight sinus, bilateral thalamic involvement is frequently encountered in in ternal CVT. However, unilateral thalamic edema may also occur, even if all internal cerebral veins are occluded. This suggests collateral venous drain age of the thalami, which is commonly insufficient in internal CVT. Patient s with unilateral congestion of the thalamus, including 3 patients reported here, had mostly left-sided involvement, indicating that right-sided unila teral thalamic involvement in CVT may be clinically silent. Copyright (C) 2 001 S. Karger AG, Basel.