Treatment of dural sinus thrombosis using selective catheterization and urokinase

Michael Horowitz, Phillip Purdy, Hal Unwin, George Carstens, Ralph Greenlee, Joe Hise, Tom Kopitnik, Hunt Batjer, Nancy Rollins, Duke Samson

Research output: Contribution to journalArticle

199 Scopus citations

Abstract

Thrombosis of the cerebral dural venous sinuses, cortical draining veins, and deep cerebral veins is a rare clinical finding. Because of its low incidence and multiple etiologies, the optimum therapy for this condition will only be elucidated by a multicenter, randomized prospective study. At our institution, we favor early and aggressive management of cerebral venous sinus thrombosis with transfemoral, venous intradural infusions of the fibrinolytic agent urokinase. To date, treatment of only 13 patients using this technique has been reported in the English literature. This report adds 12 more such treated patients. Despite the presence of preinfusion infarcts in 5 patients, four of which were hemorrhagic, we incurred no major therapeutic morbidity. Functional sinus patency was achieved in 11 of 12 patients, with our only true failure occurring in an individual with symptoms of at least 2 months' duration. Good to excellent clinical outcome was achieved in 10 of 11 patients (one newborn had inadequate follow‐up).

Original languageEnglish (US)
Pages (from-to)58-67
Number of pages10
JournalAnnals of Neurology
Volume38
Issue number1
DOIs
StatePublished - Jul 1995

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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