Pc. Gerszten et al., ISOLATED DEEP CEREBRAL VENOUS THROMBOSIS TREATED BY DIRECT ENDOVASCULAR THROMBOLYSIS, Surgical neurology, 48(3), 1997, pp. 261-266
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.