TY - JOUR
T1 - Treatment of dural sinus thrombosis using selective catheterization and urokinase
AU - Horowitz, Michael
AU - Purdy, Phillip
AU - Unwin, Hal
AU - Carstens, George
AU - Greenlee, Ralph
AU - Hise, Joe
AU - Kopitnik, Tom
AU - Batjer, Hunt
AU - Rollins, Nancy
AU - Samson, Duke
N1 - Copyright:
Copyright 2016 Elsevier B.V., All rights reserved.
PY - 1995/7
Y1 - 1995/7
N2 - Thrombosis of the cerebral dural venous sinuses, cortical draining veins, and deep cerebral veins is a rare clinical finding. Because of its low incidence and multiple etiologies, the optimum therapy for this condition will only be elucidated by a multicenter, randomized prospective study. At our institution, we favor early and aggressive management of cerebral venous sinus thrombosis with transfemoral, venous intradural infusions of the fibrinolytic agent urokinase. To date, treatment of only 13 patients using this technique has been reported in the English literature. This report adds 12 more such treated patients. Despite the presence of preinfusion infarcts in 5 patients, four of which were hemorrhagic, we incurred no major therapeutic morbidity. Functional sinus patency was achieved in 11 of 12 patients, with our only true failure occurring in an individual with symptoms of at least 2 months' duration. Good to excellent clinical outcome was achieved in 10 of 11 patients (one newborn had inadequate follow‐up).
AB - Thrombosis of the cerebral dural venous sinuses, cortical draining veins, and deep cerebral veins is a rare clinical finding. Because of its low incidence and multiple etiologies, the optimum therapy for this condition will only be elucidated by a multicenter, randomized prospective study. At our institution, we favor early and aggressive management of cerebral venous sinus thrombosis with transfemoral, venous intradural infusions of the fibrinolytic agent urokinase. To date, treatment of only 13 patients using this technique has been reported in the English literature. This report adds 12 more such treated patients. Despite the presence of preinfusion infarcts in 5 patients, four of which were hemorrhagic, we incurred no major therapeutic morbidity. Functional sinus patency was achieved in 11 of 12 patients, with our only true failure occurring in an individual with symptoms of at least 2 months' duration. Good to excellent clinical outcome was achieved in 10 of 11 patients (one newborn had inadequate follow‐up).
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U2 - 10.1002/ana.410380112
DO - 10.1002/ana.410380112
M3 - Article
C2 - 7611726
AN - SCOPUS:0029057982
SN - 0364-5134
VL - 38
SP - 58
EP - 67
JO - Annals of Neurology
JF - Annals of Neurology
IS - 1
ER -