Sagittal sinus thrombosis following minor head injury treated with continuous urokinase infusion

M D D'Alise, F Fichtel, M Horowitz
Surgical Neurology 1998, 49 (4): 430-5

BACKGROUND: Cerebral dural sinus thrombosis is a rare clinical entity. Symptoms may be vague, and left untreated thrombus progression may be fatal because of venous congestion and infarction.

METHODS: We report a case of post-traumatic dural sinus thrombosis treated with selective transfemoral, transvenous catheterization and infusion of urokinase.

RESULTS: Urokinase infusion into the dural venous sinuses using a microcatheter introduced from the femoral vein was successfully carried out, and patency of the venous sinuses was reestablished.

CONCLUSION: Venous sinus thrombosis can be an overlooked sequel to head injury. If the diagnosis is entertained, prompt performance of appropriate imaging studies should be instituted so that therapy can be initiated. The use of selective sinus catheterization using microcatheter techniques with instillation of urokinase is an excellent mode of therapy that should be considered in any patient with symptomatic occlusion.

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