Emergency endovascular treatment of cerebral sinus thrombosis with a rheolytic catheter device

Severe thrombosis of the superior sagittal, transverse, and straight sinuse s developed in a 53-year-old woman. This resulted in extensive multifocal h emorrhagic venous infarction and severe intracranial hypertension refractor y to intensive management. Endovascular therapy using a rheolytic catheter device in combination with a small amount of fibrinolytic agent led to rapi d normalization of the intracranial pressure, allowing optimization of the cerebral perfusion pressures and was followed by steady, albeit protracted, clinical improvement. The patient not only survived but also left the hosp ital with minimal neurologic deficit. The rheolytic catheter endovascular t reatment is, in the opinion of the authors, the treatment of choice for pat ients with life-threatening cerebral sinus thrombosis.