Abstract
A 16-year-old girl was diagnosed with widely distributed dural sinus thrombosis (DST) and a haemorrhagic infarct in the left parietal lobe. Despite of heparin treatment, pronounced aggravation of symptoms was observed. Through a femoral vein approach a micro-catheter was advanced into the superior sagittal sinus and rt-PA was infused slowly, directly into the thrombus over 24 hours. A follow up angiogram showed recanalisation of sinus. The patient recovered almost completely, with only few remaining cognitive symptoms. This treatment remains experimental, but should be kept in mind for DST-patients unresponsive to heparin treatment.
MeSH terms
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Adolescent
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Catheterization
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Contraceptives, Oral / adverse effects
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Female
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Fibrinolytic Agents / administration & dosage*
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Follow-Up Studies
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Humans
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Infusions, Intralesional
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Lateral Sinus Thrombosis / chemically induced
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Lateral Sinus Thrombosis / diagnostic imaging
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Lateral Sinus Thrombosis / drug therapy*
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Radiography
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Sagittal Sinus Thrombosis / chemically induced
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Sagittal Sinus Thrombosis / diagnostic imaging
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Sagittal Sinus Thrombosis / drug therapy*
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Superior Sagittal Sinus
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Thrombolytic Therapy / methods*
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Tissue Plasminogen Activator / administration & dosage*
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Treatment Outcome
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Venous Thrombosis / chemically induced
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Venous Thrombosis / diagnostic imaging
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Venous Thrombosis / drug therapy*
Substances
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Contraceptives, Oral
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Fibrinolytic Agents
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Tissue Plasminogen Activator