Background: Isolated thrombosis of the deep cerebral venous system is very rare and is associated with a poor prognosis. Antithrombin III (AT III) deficiency is a disorder of hypercoagulability associated with deep venous thrombosis and recurrent pulmonary emboli. We report a case of an 18-year-old man who presented with spontaneous thrombosis of the deep cerebral veins and straight dural sinus as the initial presentation of a previously undiagnosed AT III deficiency.
Methods: The patient was managed using direct endovascular infusion of the fibrinolytic agent urokinase followed by intravenous heparin.
Results: The technique was successful in establishing patency of the deep cerebral venous system. The patient experienced a good clinical outcome.
Conclusions: Direct endovascular thrombolysis is a potentially effective management strategy for isolated thrombosis of the deep cerebral venous system.