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.
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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)
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Chemical References |
- Urokinase-Type Plasminogen Activator
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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)
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