title: Endovascular thrombolysis for pediatric cerebral sinus venous thrombosis with tissue plasminogen activator and abciximab.
abstract: Cerebral sinus venous thrombosis (CSVT) is a relatively rare but potentially devastating disease. Medical management of CSVT with systemic anticoagulation has been the mainstay treatment strategy with these patients. However, some patients may not respond to this treatment or may present with very severe symptoms indicating more aggressive management strategies. The authors present the case of a pediatric patient who presented with severe CSVT, who underwent successful recanalization with endovascular tissue plasminogen activator (tPA) and abciximab. To the authors' knowledge there are no cases of endovascular thrombolysis for CSVT described in the literature in which abciximab has been used in conjunction with tPA. The authors also review the literature regarding the agents used and outcome in pediatric patients with CSVT after endovascular thrombolysis. The use of abciximab in conjunction with tPA may be considered in patients whose blood is hypercoagulable and in whom the treatment strategy is to obtain acute recanalization and long-term venous patency. However, the use of adjunctive agents increases the risk of hemorrhagic complications and must be done judiciously.
authors.affiliation: Departments of Neurosurgery and.
authors.forename: Imad S
authors.initials: IS
authors.lastname: Khan
authors.forename: Travis R
authors.initials: TR
authors.lastname: Ladner
authors.forename: Komal F
authors.initials: KF
authors.lastname: Satti
authors.forename: Moneeb
authors.initials: M
authors.lastname: Ehtesham
authors.forename: Lori C
authors.initials: LC
authors.lastname: Jordan
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Singer
mesh_terms: D000077284:Abciximab; D000293:Adolescent; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000925:Anticoagulants / Q000627:therapeutic use*; D002544:Cerebral Infarction / Q000209:etiology; D057510:Endovascular Procedures; D006261:Headache / Q000209:etiology; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D010296:Parietal Lobe / Q000473:pathology; D012851:Sinus Thrombosis, Intracranial / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D007140:Immunoglobulin Fab Fragments; D010959:Tissue Plasminogen Activator; D000077284:Abciximab