Treatment of sagittal sinus thrombosis associated with cerebral hemorrhage and intracranial hypertension.

Journal Article (Journal Article)

Two cases of complete sagittal sinus occlusion with multiple brain hemorrhages, elevated intracranial pressure, and disseminated intravascular coagulation are described. These patients were successfully managed using pentobarbital-induced coma to ameliorate intracranial pressure elevation. This therapy was combined with monitoring of intracranial pressure and intermittent drainage of cerebrospinal fluid to further control intracranial pressure elevations. Thrombus and coagulopathy resolved with pentobarbital alone in one patient and after pentobarbital plus heparin therapy in the second patient. It is suggested that cases of severe distal sagittal sinus thrombosis with brain hemorrhage and intracranial hypertension may benefit from combined pentobarbital coma and intraventricular drainage. This allows for stabilization of bleeding tendencies before instituting heparin therapy when necessary. Management of sagittal sinus thrombosis with barbiturates or ventricular drainage is best performed in an intensive care unit environment with continuous monitoring of intracranial pressure and substantial electrophysiologic and neuroradiologic support.

Full Text

Duke Authors

Cited Authors

  • Hanley, DF; Feldman, E; Borel, CO; Rosenbaum, AE; Goldberg, AL

Published Date

  • July 1988

Published In

Volume / Issue

  • 19 / 7

Start / End Page

  • 903 - 909

PubMed ID

  • 3388462

International Standard Serial Number (ISSN)

  • 0039-2499

Digital Object Identifier (DOI)

  • 10.1161/01.str.19.7.903


  • eng

Conference Location

  • United States