[Local thrombolysis of sinus thrombosis].
A 16-year-old girl was diagnosed with widely distributed dural sinus thrombosis (DST) and a haemorrhagic infarct in the left parietal lobe. Despite of heparin treatment, pronounced aggravation of symptoms was observed. Through a femoral vein approach a micro-catheter was advanced into the superior sagittal sinus and rt-PA was infused slowly, directly into the thrombus over 24 hours. A follow up angiogram showed recanalisation of sinus. The patient recovered almost completely, with only few remaining cognitive symptoms. This treatment remains experimental, but should be kept in mind for DST-patients unresponsive to heparin treatment.
Soll
Nicolai Højmose
NH
Røntgendiagnostisk Afdeling, Odense Universitetshospital, DK-5000 Odense C, Denmark. nsoll@hotmail.com
Vestergård
Karsten
K
Nepper-Rasmussen
Jørgen
J
D000293:Adolescent; D002404:Catheterization; D003276:Contraceptives, Oral / Q000009:adverse effects; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D036502:Infusions, Intralesional; D020227:Lateral Sinus Thrombosis / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011859:Radiography; D020225:Sagittal Sinus Thrombosis / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000188:drug therapy*; D054063:Superior Sagittal Sinus; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000188:drug therapy*
D003276:Contraceptives, Oral; D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator