Treatment of Acute Superior Sagittal Sinus Thrombosis by t-PA Infusion via Venography—Direct Thrombolytic Therapy in the Acute Phase

Background Dural sinus thrombosis is a relatively rare syndrome, often with a very poor prognosis. Systemic anticoagulant therapy has produced poor results; therefore rapid recanalization of the affected vessels is essential. The recent advancements in angiographic technique and catheter technology enable us to perform direct selective venography. Case report We observed a case of acute superior sagittal sinus thrombosis in a pregnant woman. The patient’s consciousness level and motor function gradually deteriorated. Direct thrombolysis was performed via venography. Results The patient was treated successfully by thrombolysis with infusion of t-PA via selective venography within 2 days of rapid clinical deterioration and sustained a dramatic improvement of her neurological deficits. Conclusions Direct thrombolysis via selective venography is considered a safe and useful treatment for dural sinus thrombosis in the acute phase.