Successful delayed thrombolysis for cerebral venous and dural sinus thrombosis: a case report and review of the literature.
Cerebral venous and dural sinus thrombosis (CVDST) is a rare but not uncommon life-threatening disease accounting for less than 1% of stroke, affecting people of any age group, predominantly the extremes of age. CVDST carries a variable prognosis: although the majority of cases are associated with complete recovery, outcome may be fatal in less than 10% of patients. Thrombolysis has been widely used in CVDST in patients with rapidly deteriorating symptoms who fail to improve despite adequate anticoagulation, but the exact therapeutic time window remains unclear. We report a case of CVDST with rapid clinical deterioration despite therapeutic anticoagulation treated with direct endovascular thrombolysis with intravenous recombinant tissue plasminogen activator 1 week after presentation with complete recovery, and we present a review of the literature on the efficacy and safety of thrombolysis in CVDST.
Hocker
Sara E
SE
Department of Neurology, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois 60153, USA.
Dafer
Rima M
RM
Hacein-Bey
Lotfi
L
D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage; D002533:Cerebral Angiography; D002550:Cerebral Veins / Q000187:drug effects* / Q000503:physiopathology; D003128:Coma / Q000209:etiology / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007275:Injections, Intravenous; D020127:Recovery of Function / Q000187:drug effects / Q000502:physiology; D012851:Sinus Thrombosis, Intracranial / Q000188:drug therapy* / Q000503:physiopathology; D015912:Thrombolytic Therapy / Q000379:methods / Q000592:standards*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures; D020246:Venous Thrombosis / Q000188:drug therapy* / Q000503:physiopathology
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006493:Heparin; D010959:Tissue Plasminogen Activator