Endovascular thrombolysis in deep cerebral venous thrombosis

• Published in: American journal of neuroradiology : AJNR Vol. 18; no. 3; pp. 502 - 506
• Main Authors: Spearman, MP, Jungreis, CA, Wehner, JJ, Gerszten, PC, Welch, WC
• Format: Journal Article
• Language: English
• Published: Oak Brook, IL Am Soc Neuroradiology 01-03-1997; American Society of Neuroradiology
• Subjects: Adolescent; Adult; Basal Ganglia Diseases - diagnostic imaging; Basal Ganglia Diseases - drug therapy; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Brain Edema - diagnostic imaging; Brain Edema - drug therapy; Case Reports; Cerebral Angiography; Cerebral Infarction - diagnostic imaging; Cerebral Infarction - drug therapy; Cerebral Veins - diagnostic imaging; Dominance, Cerebral - physiology; Female; Humans; Hydrocephalus - diagnostic imaging; Hydrocephalus - drug therapy; Intracranial Embolism and Thrombosis - diagnostic imaging; Intracranial Embolism and Thrombosis - drug therapy; Male; Medical sciences; Pharmacology. Drug treatments; Sinus Thrombosis, Intracranial - diagnostic imaging; Sinus Thrombosis, Intracranial - drug therapy; Thalamic Diseases - diagnostic imaging; Thalamic Diseases - drug therapy; Thrombolytic Therapy - instrumentation; Tomography, X-Ray Computed; Treatment Outcome; Urokinase-Type Plasminogen Activator - administration & dosage; Human; Nervous system diseases; Acute; Cardiovascular disease; Endovascular route; Thrombosis; Cerebral disorder; Venous disease; Vascular disease; Case study; Chemotherapy; Treatment; Central nervous system disease; Cranial venous sinus; Urokinase(drug); Cerebrovascular disease; Fibrinolytic
• ISSN: 0195-6108; 1936-959X

We present two cases of acute thrombosis of the internal cerebral veins, vein of Galen, and straight sinus without sagittal sinus involvement. Both patients had hydrocephalus and severe edema of the basal ganglia and thalami, one with hemorrhagic infarction of the thalamus. Because both patients rapidly deteriorated to a comatose state, endovascular thrombolysis was performed with urokinase infusion of the deep venous structures. Thrombolysis was continued until a patent channel with brisk flow in the venous structures was achieved. Both patients survived with minimal neurologic deficits.