Open thrombectomy combined with thrombolysis in massive intracranial sinus thrombosis

Kourtopoulos, Harry; Christie, Martin; Rath, Benjamin

doi:10.1007/bf01400670

Cited by 27 publications

(14 citation statements)

References 8 publications

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“…Therefore, 72 studies [6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77], totalling 169 patients were included in the review. Ten studies reported on 5 or more patients (89 patients), the largest case series with 18 patients [71].…”

Section: Resultsmentioning

confidence: 99%

Thrombolytics for Cerebral Sinus Thrombosis

Canhão¹,

Falcão²,

Ferro³

2003

Cerebrovasc Dis

219

112

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Background and Purpose: The use of thrombolytics is frequently mentioned in patients with cerebral venous or dural sinus thrombosis (CVDST) who deteriorate despite anticoagulant therapy. The aim of this review was to collect all the published information about their use in CVDST and to assess their efficacy and safety. Methods: To find cases of CVDST treated with thrombolytics, we performed a MEDLINE search from 1966 to July 2001, checked all reference lists of studies found and hand searched volumes of 11 journals. Data was extracted by means of a standardised data extraction form. Proportions and 95% confidence intervals (CI) were calculated for outcomes and complications of thrombolytics. Cases were stratified according to variables that may influence the outcome and subgroups were compared by odds ratios and 95% CI. Results: No randomised clinical trial (RCT) was found. Seventy-two studies (169 patients) were included. Urokinase was the thrombolytic most frequently administered (76%). In the majority of cases the thrombolytic was locally infused in the occluded sinus (88%). At discharge, 10 cases (7%; 95% CI 3–12%) were dependent and 9 cases (5%; 95% CI 2–9%) died. Intracranial haemorrhages occurred in 17% of cases. In 5% they were associated with clinical deterioration. Extracranial haemorrhages occurred in 21%, but only 2% required blood transfusion. Conclusions: Thrombolytics appeared to be reasonably safe in CVDST, but its efficacy cannot be assessed from the published data. Considering that CVDST is an uncommon disease, a randomised controlled trial to assess effectiveness and safety of local thrombolytics in cases of CVDST with poor prognosis is difficult but not impossible to undertake, on a multicentre international collaboration trial.

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Section: Resultsmentioning

confidence: 99%

Thrombolytics for Cerebral Sinus Thrombosis

Canhão¹,

Falcão²,

Ferro³

2003

Cerebrovasc Dis

219

112

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“…The use of direct surgical thrombectomy or venous sinus bypass has been described by several authors [35, 36, 37, 38, 39]. Although these techniques may result in dramatic improvement, they are associated with tremendous risk in the small child or neonate.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Dural Sinus Thrombosis in Children

Lancon¹,

Killough

Tibbs³

et al. 1999

Pediatr Neurosurg

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The clinical course of spontaneous dural sinus thrombosis in children varies from indolent to fulminant. Although many different etiologies for the development of dural sinus thrombosis have been described, a full recovery can be anticipated in most children following rehydration and the administration of systemic antibiotics. Steroids, systemic anticoagulation and intrasinus thrombolysis may be beneficial in selected patients, although the efficacy of these therapies has not been established prospectively in children. We reviewed 12 pediatric patients with spontaneous dural sinus thrombosis (1978-1998) to determine the etiology, clinical course and best treatment options. In the absence of a hypercoagulable state, pediatric patients generally recover well with rehydration and antibiotics and do not require anticoagulation.

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“…With treatment the long-term prognosis for most patients with CVST is good, though a small percentage die or are left with significant disability [2]. Hydrocephalus from CVST is rare, and this patient represents the fifth case published in the English language literature [4][5][6].…”

Section: Discussionmentioning

confidence: 98%