Endovascular thrombolysis in deep cerebral venous thrombosis.
We present two cases of acute thrombosis of the internal cerebral veins, vein of Galen, and straight sinus without sagittal sinus involvement. Both patients had hydrocephalus and severe edema of the basal ganglia and thalami, one with hemorrhagic infarction of the thalamus. Because both patients rapidly deteriorated to a comatose state, endovascular thrombolysis was performed with urokinase infusion of the deep venous structures. Thrombolysis was continued until a patent channel with brisk flow in the venous structures was achieved. Both patients survived with minimal neurologic deficits.
Spearman
M P
MP
Department of Radiology, University of Pittsburgh Medical Center, PA 15213, USA.
Jungreis
C A
CA
Wehner
J J
JJ
Gerszten
P C
PC
Welch
W C
WC
D000293:Adolescent; D000328:Adult; D001480:Basal Ganglia Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000188:drug therapy; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy; D002550:Cerebral Veins / Q000000981:diagnostic imaging; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging / Q000188:drug therapy; D002542:Intracranial Embolism and Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D012851:Sinus Thrombosis, Intracranial / Q000000981:diagnostic imaging / Q000188:drug therapy*; D013786:Thalamic Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy; D015912:Thrombolytic Therapy / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*
D014568:Urokinase-Type Plasminogen Activator