This study is to explore and evaluate the efficacy and safety of local
thrombolytic therapy in superior sagittal sinus in patients with severe cerebral venous
sinus thrombosis during puerperium, as well as the efficacy and safety of anti-platelet aggregation treatment for preventing recurrence. Twelve patients during postpartum period with cerebral venous
sinus thrombosis were received local
thrombolytic therapy by placing a micro-
catheter at the distal end of superior sagittal sinus from January 2008 to December 2013. All the patients accepted mechanical
thrombus maceration before local intrasinus
thrombolytic therapy, and were treated with
low molecular weight heparin in the acute phase. After local
thrombolytic therapy, anti-platelet aggregation treatment was performed for 6 months. Follow-up data included lumber
puncture, fundus examination and magnetic resonance venography (MRV) once per half year for 6-70 months. At discharge, the intracranial pressure of 12 patients reduced to below 200 mmH2O. DSA or MRV confirmed that superior sagittal sinus of 9 patients were smooth. The cortex venous and deep venous were recovered to normal. Superior sagittal sinus of 3 patients recanalized partly. Cortex venous and deep venous was compensated. The follow-up study indicated that no
thrombosis and new neurological symptoms occurred among all patients. Local thrombolytic treatment is safe and effective in patients with severe cerebral venous
sinus thrombosis during puerperium. The collateral circulation compensation is the main recovery factor. And it is also safe and effective for anti-platelet aggregation treatment to prevent recurrence of cerebral venous
sinus thrombosis.