Direct thrombolysis for cerebral venous sinus thrombosis.
Cerebral venous sinus thrombosis (CVST) is an increasingly diagnosed disease with a wide range of symptoms, ranging from a mild headache to cerebral herniation. A potentially devastating syndrome, CVST has been associated with a mortality rate of 6-10%. In prospective studies, the overall rate of death and dependency from CVST ranges from 8.8 to 44.4%. Systemic anticoagulation remains the first-line treatment. However, a percentage of patients deteriorate despite medical therapy. These cases have resulted in the development of thrombolysis or endovascular treatment for CVST. Initial reports of the use of endovascular treatment of CVST have been promising. However, enthusiasm for the use of endovascular thrombolysis and thrombectomy should be tempered by an understanding of possible risks such as intracerebral hemorrhage and/or vessel dissection. The authors review the literature regarding endovascular treatment of CVST with a description of the chemical and mechanical thrombolytic techniques.
Rahman
Maryam
M
Department of Neurosurgery, University of Florida, Gainesville, Florida, USA. maryam.rahman@neurosurgery.ufl.edu
Velat
Gregory J
GJ
Hoh
Brian L
BL
Mocco
J
J
D002404:Catheterization / Q000379:methods; D003131:Combined Modality Therapy; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D011446:Prospective Studies; D012851:Sinus Thrombosis, Intracranial / Q000188:drug therapy* / Q000601:surgery*; D017131:Thrombectomy / Q000379:methods*; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome
D005343:Fibrinolytic Agents