Recanalization for straight sinus thrombosis through combined mechanical thrombectomy: A case report.
Case report
Mechanical thrombectomy
Recanalization
Sinus thrombosis
Straight sinus
Journal
Surgical neurology international
ISSN: 2229-5097
Titre abrégé: Surg Neurol Int
Pays: United States
ID NLM: 101535836
Informations de publication
Date de publication:
2022
2022
Historique:
received:
10
06
2022
accepted:
22
06
2022
entrez:
20
7
2022
pubmed:
21
7
2022
medline:
21
7
2022
Statut:
epublish
Résumé
Systemic anticoagulation has been the standard treatment for cerebral venous sinus thrombosis (CVT). Although endovascular treatments, including mechanical thrombectomy (MT), have been reported to be effective for CVT, no clear evidence has been established. A 51-year-old woman who had been administered oral contraceptive pills was transferred to our hospital with altered consciousness and disorientation. Computed tomography (CT) revealed a hyperdense signal in the straight sinus (StS), and CT angiography revealed a defect in the basal vein and StS, leading to a diagnosis of StS thrombosis. Although systemic anticoagulation through unfractionated heparin was performed, her neurological condition deteriorated, and venous ischemia was observed on CT the next day. She then underwent MT. Partial recanalization was achieved with an aspiration catheter and a stent retriever. Her neurological condition improved tremendously, and venous ischemia was reversed following MT. She was discharged 3 weeks later without neurological deficits with oral anticoagulant. This was a relatively rare case with CVT confined to StS. Immediate combined MT for StS thrombosis can improve venous circulation, make the venous ischemia reversible, and improve patient outcomes, even if it results in partial recanalization.
Sections du résumé
Background
UNASSIGNED
Systemic anticoagulation has been the standard treatment for cerebral venous sinus thrombosis (CVT). Although endovascular treatments, including mechanical thrombectomy (MT), have been reported to be effective for CVT, no clear evidence has been established.
Case Description
UNASSIGNED
A 51-year-old woman who had been administered oral contraceptive pills was transferred to our hospital with altered consciousness and disorientation. Computed tomography (CT) revealed a hyperdense signal in the straight sinus (StS), and CT angiography revealed a defect in the basal vein and StS, leading to a diagnosis of StS thrombosis. Although systemic anticoagulation through unfractionated heparin was performed, her neurological condition deteriorated, and venous ischemia was observed on CT the next day. She then underwent MT. Partial recanalization was achieved with an aspiration catheter and a stent retriever. Her neurological condition improved tremendously, and venous ischemia was reversed following MT. She was discharged 3 weeks later without neurological deficits with oral anticoagulant.
Conclusion
UNASSIGNED
This was a relatively rare case with CVT confined to StS. Immediate combined MT for StS thrombosis can improve venous circulation, make the venous ischemia reversible, and improve patient outcomes, even if it results in partial recanalization.
Identifiants
pubmed: 35855139
doi: 10.25259/SNI_535_2022
pii: 10.25259/SNI_535_2022
pmc: PMC9282811
doi:
Types de publication
Case Reports
Langues
eng
Pagination
293Informations de copyright
Copyright: © 2022 Surgical Neurology International.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
Références
Interv Neuroradiol. 2017 Dec;23(6):605-608
pubmed: 28944707
Eur J Neurol. 2017 Oct;24(10):1203-1213
pubmed: 28833980
JAMA Neurol. 2020 Aug 1;77(8):966-973
pubmed: 32421159
J Neurointerv Surg. 2018 Aug;10(8):803-810
pubmed: 29871990
Stroke. 2004 Mar;35(3):664-70
pubmed: 14976332
Cerebrovasc Dis. 2003;15(3):159-66
pubmed: 12646773
J Am Heart Assoc. 2017 Jun 13;6(6):
pubmed: 28611097
Stroke. 2015 May;46(5):1263-8
pubmed: 25899238
Stroke. 2007 Feb;38(2):337-42
pubmed: 17204682
J Neurointerv Surg. 2015 Mar;7(3):e10
pubmed: 24565759
J Neurointerv Surg. 2017 Nov;9(11):1086-1092
pubmed: 28213478
Am J Transl Res. 2021 Jun 15;13(6):6921-6928
pubmed: 34306444
World Neurosurg. 2019 Jul;127:e1097-e1103
pubmed: 30980969
Stroke. 2011 Apr;42(4):1158-92
pubmed: 21293023
J Neurol Neurosurg Psychiatry. 2001 Jan;70(1):105-8
pubmed: 11118257
Interv Neuroradiol. 2014 May-Jun;20(3):336-44
pubmed: 24976097
J Neurointerv Surg. 2016 Jun;8(6):e24
pubmed: 26019186
J Neurointerv Surg. 2014 Jun;6(5):e32
pubmed: 24049112