Local Thrombolysis in Severe Cerebral Venous and Sinus Thrombosis – Two Case Reports

Authors: L. Pospíšilová 1;  D. Krajíčková 1;  A. Krajina 2;  J. Náhlovský 3;  M. Vališ 1
Authors‘ workplace: LF UK a FN Hradec Králové Neurologická klinika 1;  LF UK a FN Hradec Králové Radiologická klinika 2;  LF UK a FN Hradec Králové Neurochirugická klinika 3
Published in: Cesk Slov Neurol N 2014; 77/110(1): 117-120
Category: Case Report


Unlike arterial thrombosis, cerebral venous and sinus thrombosis is a relatively rare disease, accounting for 0.5–1% of all strokes. It may be associated with serious sequelae and often affects young individuals. Currently, standard treatment involves anticoagulant therapy with intravenous heparin or subcutaneous low molecular weight heparin. Over the recent years, local thrombolysis has also been performed using recombinant tissue plasminogen activator administered directly to the clot, usually combined with simultaneous mechanical thrombectomy. Due to the continuing insufficiency of reliable evidence, this treatment is used in selected patients only. We report two cases of patients successfully treated with local thrombolysis. In the first case, thrombolysis was performed on the third day following admission to a hospital as the clinical picture did not improved despite treatment with therapeutic doses of anticoagulants. The second case is a woman who was urgently treated with local thrombolysis, to respond to her poor condition and rapidly decreasing level of consciousness on admission.

Key words:
cerebral venous and sinus thrombosis – heparin – thrombolysis

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


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Paediatric neurology Neurosurgery Neurology

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