Treatment of acute superior sagittal sinus thrombosis by t-PA infusion via venography--direct thrombolytic therapy in the acute phase.
BACKGROUND
Dural sinus thrombosis is a relatively rare syndrome, often with a very poor prognosis. Systemic anticoagulant therapy has produced poor results; therefore rapid recanalization of the affected vessels is essential. The recent advancements in angiographic technique and catheter technology enable us to perform direct selective venography.


METHODS
We observed a case of acute superior sagittal sinus thrombosis in a pregnant woman. The patient's consciousness level and motor function gradually deteriorated. Direct thrombolysis was performed via venography.


RESULTS
The patient was treated successfully by thrombolysis with infusion of t-PA via selective venography within 2 days of rapid clinical deterioration and sustained a dramatic improvement of her neurological deficits.


CONCLUSIONS
Direct thrombolysis via selective venography is considered a safe and useful treatment for dural sinus thrombosis in the acute phase.
Niwa
J
J
Department of Neurosurgery, Hakodate City Hospital, Hokkaido, Japan.
Ohyama
H
H
Matumura
S
S
Maeda
Y
Y
Shimizu
T
T
D000208:Acute Disease; D000328:Adult; D003392:Cranial Sinuses; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D010690:Phlebography; D010960:Plasminogen Activators / Q000627:therapeutic use*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000628:therapy*; D012851:Sinus Thrombosis, Intracranial / Q000628:therapy*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator