ISOLATED DEEP CEREBRAL VENOUS THROMBOSIS TREATED BY DIRECT ENDOVASCULAR THROMBOLYSIS

BACKGROUND Isolated thrombosis of the deep cerebral venous system is v ery rare and is associated with a poor prognosis. Antithrombin III (AT III) deficiency is a disorder of hypercoagulability associated with d eep venous thrombosis and recurrent pulmonary emboli. We report a case of an 18-year-old man who presented with spontaneous thrombosis of th e deep cerebral veins and straight dural sinus as the initial presenta tion of a previously undiagnosed AT III deficiency. METHODS The patien t was managed using direct endovascular infusion of the fibrinolytic a gent urokinase followed by intravenous heparin. RESULTS The technique was successful in establishing patency of the deep cerebral venous sys tem. The patient experienced a good clinical outcome. CONCLUSIONS Dire ct endovascular thrombolysis is a potentially effective management str ategy for isolated thrombosis of the deep cerebral venous system. (C) 1997 by Elsevier Science Inc.