Expansion of a haematoma after urokinase thrombolysis of superior sagittal sinus thrombosis

C. J. Moran, D. W.T. Cross, C. P. Derdeyn, A. W. Dromerick, R. G. Dacey

Research output: Contribution to journalArticlepeer-review

Abstract

Thrombosis of the superior sagittal sinus may result in significant morbidity and recently up to 20% mortality. Primary treatment has consisted of anticoagulation and methods for controlling increased intracranial pressure. The development of interventional neuroradiologic techniques has enabled infusion of thrombolytics at the clot. We describe a woman with a cerebral haemorrhage due to a thrombosed superior sagittal sinus. Her decreased level of consciousness and increasing hemiparesis prompted direct thrombolytic therapy (urokinase). Flow was restored in the occluded sinus, but an acute expansion of the haematoma an hour after conclusion of the infusion resulted in temporary worsening of her neurologic deficits. Although the ultimate outcome was satisfactory, the possibility of further intracranial bleeding must be balanced against the risk of death with conservative therapy.

Original languageEnglish
Pages (from-to)81-86
Number of pages6
JournalInterventional Neuroradiology
Volume3
Issue number1
StatePublished - Mar 1 1997

Keywords

  • interventional neuroradiology, thrombolysis, urokinase
  • thrombosis, venous, superior sagittal sinus

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