Mechanical Thrombectomy for Cerebral Venous Sinus Thrombosis: A Case Series and Technical Note
| Autor: | Satya Bhusan Senapati, Bimal Prasad Padhy, Vitor Mendes Pereira, Patrick Nicholson, Gorky Medhi, Subhendu Parida |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Cranial Sinuses 03 medical and health sciences Sinus Thrombosis Intracranial 0302 clinical medicine Modified Rankin Scale medicine Humans Cerebral venous sinus thrombosis Retrospective Studies Thrombectomy business.industry Heparin Thrombolysis Middle Aged medicine.disease Thrombosis Surgery Mechanical thrombectomy Hemiparesis Treatment Outcome 030220 oncology & carcinogenesis Vomiting Female Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | World neurosurgery. 140 |
| ISSN: | 1878-8769 |
| Popis: | Background Cerebral venous sinus thrombosis is a rare cause of acute stroke. It may lead to hemorrhagic venous infarctions, brain swelling, or raised intracranial pressure and can be associated with significant mortality and morbidity. Low-molecular-weight heparin is the mainstay of treatment. Endovascular treatment is reserved for patients who deteriorate despite medical management. Methods Retrospective evaluation of our institutional databases from 2018–2019 revealed 7 patients who underwent aspiration thrombectomy using large-bore aspiration catheters for recanalization of the dural sinuses with or without intrasinus thrombolysis during the procedure. Their clinical, imaging findings, endovascular technique, and outcome are discussed. Results We treated 7 patients who did not respond to best medical management. Aspiration thrombectomy was the primary mode of endovascular treatment. Adjuvant low-dose (10 mg recombinant tissue plasminogen activator), short-duration (20-minute) intrasinus thrombolysis was used in 4 patients only during the procedure. Headache was the most common symptom, followed by seizures, focal neurologic deficits, and vomiting. There was improvement in clinical condition within 24 hours of procedure in all patients. The 30-day modified Rankin Scale score was 0 in 6 patients. One patient had residual hemiparesis and aphasia. There were no procedure-related complications. Conclusions The described technique appears to be simple, safe, and effective and results in a relatively short procedure time in achieving complete or partial recanalization of the dural sinuses in patients who deteriorate despite clinical management. Endovascular thrombectomy along with conventional medical management restores the final drainage pathway of the brain with good clinical outcome. |
| Databáze: | OpenAIRE |
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