TREATMENT OF DURAL SINUS THROMBOSIS BY UROKINASE INFUSION

To gain a preliminary understanding of the role of thrombolytic therap y for the thrombosed dural sinus, we retrospectively reviewed our init ial experience. METHODS: Seven patients, ages 25 to 71, who presented with symptomatic dural sinus thrombosis and who failed a trial of medi cal therapy were treated with direct infusion of urokinase into the th rombosed sinus. Patients received urokinase doses ranging from 20 000 to 150 000 U/h with a mean infusion time of 163 hours (range 88 to 244 hours). RESULTS: Patency of the affected dural sinus was achieved wit h antegrade flow in all patients. Six patients either improved neurolo gically over their prethrombolysis state or were healthy after thrombo lysis; one of them required angioplasty. The other patient improved af ter surgical repair of a residual dural arteriovenous fistula. The onl y complications were an infected femoral access site which resolved af ter treatment with antibiotics and hematuria which cleared after disco ntinuation of anticoagulation. CONCLUSIONS: Thrombolysis of the thromb osed dural sinus shows promise as a safe and efficacious treatment. Th e results of this study should provide the impetus for further researc h.