title: [Endovascular thrombolysis for massive cerebral venous thrombosis in a teenager with nephrotic syndrome].
abstract: Cerebral venous thrombosis is a rare but potentially severe condition in children. We present the case of a teenager with corticodependent nephrotic syndrome diagnosed at five months of age and treated with cyclosporine A. In the context of recurrence of nephrotic syndrome he presented with headache, vomiting and severe intracranial hypertension. While the raised intracranial pressure and the status epilepticus were controlled, the brain imaging revealed venous thrombosis of all venous sinus, with absence of venous drainage. He was submitted to local thrombolysis with recombinant tissue plasminogen activator, with recanalization of the venous sinuses. The outcome was favourable, without neurological deficits. In this case, the early radiologic intervention was crucial, enabling a full neurological recovery, in a teenager whose initial prognosis was very poor.
authors.affiliation: Unidade de Cuidados Intensivos Pediátricos e Unidade de Nefrologia Pediátrica, Departamento da Criança e da Família, Serviço de Imagiologia Neurológica, Hospital Santa Maria, Lisbon.
authors.forename: Paula
authors.initials: P
authors.lastname: Costa
authors.forename: Luísa
authors.initials: L
authors.lastname: Biscoito
authors.forename: Marisa
authors.initials: M
authors.lastname: Vieira
authors.forename: Mónica
authors.initials: M
authors.lastname: Marçal
authors.forename: Cristina
authors.initials: C
authors.lastname: Camilo
authors.forename: Lia
authors.initials: L
authors.lastname: Neto
authors.forename: Francisco
authors.initials: F
authors.lastname: Abecasis
authors.forename: Margarida
authors.initials: M
authors.lastname: Almeida
authors.forename: Manuela
authors.initials: M
authors.lastname: Correia
mesh_terms: D000293:Adolescent; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D020767:Intracranial Thrombosis / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D009404:Nephrotic Syndrome / Q000150:complications*; D015912:Thrombolytic Therapy / Q000379:methods; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D020246:Venous Thrombosis / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator