Treatment of dural sinus thrombosis by urokinase infusion.

Abstract

PURPOSE:

To gain a preliminary understanding of the role of thrombolytic therapy for the thrombosed dural sinus, we retrospectively reviewed our initial experience.

METHODS:

Seven patients, ages 25 to 71, who presented with symptomatic dural sinus thrombosis and who failed a trial of medical therapy were treated with direct infusion of urokinase into the thrombosed sinus. Patients received urokinase doses ranging from 20,000 to 150,000 U/h with a mean infusion time of 163 hours (range 88 to 244 hours).

RESULTS:

Patency of the affected dural sinus was achieved with antegrade flow in all patients. Six patients either improved neurologically over their prethrombolysis state or were healthy after thrombolysis; one of them required angioplasty. The other patient improved after surgical repair of a residual dural arteriovenous fistula. The only complications were an infected femoral access site which resolved after treatment with antibiotics and hematuria which cleared after discontinuation of anticoagulation.

CONCLUSIONS:

Thrombolysis of the thrombosed dural sinus shows promise as a safe and efficacious treatment. The results of this study should provide the impetus for further research.

• Authors: T P Smith, R T Higashida, S L Barnwell, V V Halbach, C F Dowd, K W Fraser, G P Teitelbaum, G B Hieshima
• Journal: AJNR. American journal of neuroradiology (AJNR Am J Neuroradiol) Vol. 15 Issue 5 Pg. 801-7 (May 1994) ISSN: 0195-6108 [Print] United States
• PMID: 8059645 (Publication Type: Journal Article)

Chemical References

• Urokinase-Type Plasminogen Activator

Topics

• Adult
• Aged
• Cerebral Angiography
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Dura Mater (blood supply)
• Female
• Follow-Up Studies
• Humans
• Infusions, Intravenous
• Male
• Middle Aged
• Neurologic Examination (drug effects)
• Sinus Thrombosis, Intracranial (diagnostic imaging, drug therapy, etiology)
• Thrombolytic Therapy
• Treatment Outcome
• Urokinase-Type Plasminogen Activator (administration & dosage, adverse effects)