Treatment of Acute Superior Sagittal Sinus Thrombosis by t-PA Infusion via Venography—Direct Thrombolytic Therapy in the Acute Phase

Abstract 

Background

Dural sinus thrombosis is a relatively rare syndrome, often with a very poor prognosis. Systemic anticoagulant therapy has produced poor results; therefore rapid recanalization of the affected vessels is essential. The recent advancements in angiographic technique and catheter technology enable us to perform direct selective venography.

Case report

We observed a case of acute superior sagittal sinus thrombosis in a pregnant woman. The patient’s consciousness level and motor function gradually deteriorated. Direct thrombolysis was performed via venography.

Results

The patient was treated successfully by thrombolysis with infusion of t-PA via selective venography within 2 days of rapid clinical deterioration and sustained a dramatic improvement of her neurological deficits.

Conclusions

Direct thrombolysis via selective venography is considered a safe and useful treatment for dural sinus thrombosis in the acute phase.

Keywords:  Thrombolysis, superior sagittal sinus, tissue-plasminogen activator, venography, acute phase