Isolated deep cerebral venous thrombosis treated by direct endovascular thrombolysis.
BACKGROUND
Isolated thrombosis of the deep cerebral venous system is very rare and is associated with a poor prognosis. Antithrombin III (AT III) deficiency is a disorder of hypercoagulability associated with deep venous thrombosis and recurrent pulmonary emboli. We report a case of an 18-year-old man who presented with spontaneous thrombosis of the deep cerebral veins and straight dural sinus as the initial presentation of a previously undiagnosed AT III deficiency.


METHODS
The patient was managed using direct endovascular infusion of the fibrinolytic agent urokinase followed by intravenous heparin.


RESULTS
The technique was successful in establishing patency of the deep cerebral venous system. The patient experienced a good clinical outcome.


CONCLUSIONS
Direct endovascular thrombolysis is a potentially effective management strategy for isolated thrombosis of the deep cerebral venous system.
Gerszten
P C
PC
Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pennsylvania, USA.
Welch
W C
WC
Spearman
M P
MP
Jungreis
C A
CA
Redner
R L
RL
D000328:Adult; D020152:Antithrombin III Deficiency; D001778:Blood Coagulation Disorders / Q000150:complications / Q000175:diagnosis*; D002550:Cerebral Veins; D003937:Diagnosis, Differential; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000188:drug therapy* / Q000209:etiology; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D010960:Plasminogen Activators / Q000627:therapeutic use*; D012851:Sinus Thrombosis, Intracranial / Q000188:drug therapy; D015912:Thrombolytic Therapy / Q000379:methods; D014057:Tomography, X-Ray Computed; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator