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Abstract

Treatment of dural sinus thrombosis by urokinase infusion.

T P Smith, R T Higashida, S L Barnwell, V V Halbach, C F Dowd, K W Fraser, G P Teitelbaum and G B Hieshima
American Journal of Neuroradiology May 1994, 15 (5) 801-807;
T P Smith
Department of Radiology, University of California, San Francisco 94143-0628.
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R T Higashida
Department of Radiology, University of California, San Francisco 94143-0628.
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S L Barnwell
Department of Radiology, University of California, San Francisco 94143-0628.
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V V Halbach
Department of Radiology, University of California, San Francisco 94143-0628.
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C F Dowd
Department of Radiology, University of California, San Francisco 94143-0628.
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K W Fraser
Department of Radiology, University of California, San Francisco 94143-0628.
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G P Teitelbaum
Department of Radiology, University of California, San Francisco 94143-0628.
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G B Hieshima
Department of Radiology, University of California, San Francisco 94143-0628.
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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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American Journal of Neuroradiology
Vol. 15, Issue 5
1 May 1994
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T P Smith, R T Higashida, S L Barnwell, V V Halbach, C F Dowd, K W Fraser, G P Teitelbaum, G B Hieshima
Treatment of dural sinus thrombosis by urokinase infusion.
American Journal of Neuroradiology May 1994, 15 (5) 801-807;

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Treatment of dural sinus thrombosis by urokinase infusion.
T P Smith, R T Higashida, S L Barnwell, V V Halbach, C F Dowd, K W Fraser, G P Teitelbaum, G B Hieshima
American Journal of Neuroradiology May 1994, 15 (5) 801-807;
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  • Nonrandomized Comparison of Local Urokinase Thrombolysis Versus Systemic Heparin Anticoagulation for Superior Sagittal Sinus Thrombosis Editorial Comment
  • Cerebral venous thrombosis: anticoagulants or thrombolyic therapy?
  • Endovascular Treatment of Dural Sinus Thrombosis With Rheolytic Thrombectomy and Intra-Arterial Thrombolysis
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  • Diffusion- and Perfusion-Weighted MR Imaging of Dural Sinus Thrombosis
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  • Application of a Rheolytic Thrombectomy Device in the Treatment of Dural Sinus Thrombosis: A New Technique
  • Cerebral Venous Thrombosis : Combined Intrathrombus rtPA and Intravenous Heparin
  • Rapid Thrombectomy of Superior Sagittal Sinus and Transverse Sinus Thrombosis with a Rheolytic Catheter Device
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