Endovascular Thrombectomy and Thrombolysis for Cerebral Venous Sinus Thrombosis Unresponsive to Heparin
V Lau, R Lee, WK Tso, WM Lui, S Lee
Hong Kong J Radiol 2012;15:101-4
Cerebral venous sinus thrombosis is a rare, but potentially life-threatening, disease accounting for less than 1% of stroke. Most patients with dural sinus thrombosis improve after treatment with heparin, but a subgroup of patients has a poor prognosis with continued deterioration. Those patients may benefit from endovascular thrombolysis. We report on a young woman with dural sinus thrombosis, who was taking an oral contraceptive, and had continued deterioration despite heparin therapy. Subsequently, she was treated with endovascular thrombectomy and thrombolysis, and showed significant clinical improvement and radiological resolution in follow-up imaging. The literature on the efficacy and safety of thrombolysis in dural sinus thrombosis is reviewed.
中文摘要
血管內血栓清除術和溶栓治療肝素無反應的腦內靜脈竇血栓病例
劉泳恆、李雷釗、曹偉權、呂偉文、李偉聯
腦內靜脈竇血栓形成是一種罕見但可致命的病，佔中風患者少於1%。大多數患者經肝素治療後腦硬 膜竇血栓改善，但仍有一小部分患者經治療後情況繼續惡化預後很差，這些患者接受血管內溶栓治 療可能有助改善病情。本文報告一名患有腦硬膜竇血栓的年青女性，她一向服食避孕丸，肝素治療 對她無效。最終病人接受血管內血栓清除術和溶栓治療，病情顯著改善，影像掃瞄亦顯示血栓有消 失的跡象。本文並回顧有關溶栓治療腦硬膜竇血栓的效用及安全性的文獻。