Treatment of dural sinus thrombosis by urokinase infusion.

Published

Journal Article

PURPOSE: To gain a preliminary understanding of the role of thrombolytic therapy for the thrombosed dural sinus, we retrospectively reviewed our initial experience. METHODS: Seven patients, ages 25 to 71, who presented with symptomatic dural sinus thrombosis and who failed a trial of medical therapy were treated with direct infusion of urokinase into the thrombosed sinus. Patients received urokinase doses ranging from 20,000 to 150,000 U/h with a mean infusion time of 163 hours (range 88 to 244 hours). RESULTS: Patency of the affected dural sinus was achieved with antegrade flow in all patients. Six patients either improved neurologically over their prethrombolysis state or were healthy after thrombolysis; one of them required angioplasty. The other patient improved after surgical repair of a residual dural arteriovenous fistula. The only complications were an infected femoral access site which resolved after treatment with antibiotics and hematuria which cleared after discontinuation of anticoagulation. CONCLUSIONS: Thrombolysis of the thrombosed dural sinus shows promise as a safe and efficacious treatment. The results of this study should provide the impetus for further research.

Full Text

Duke Authors

Cited Authors

  • Smith, TP; Higashida, RT; Barnwell, SL; Halbach, VV; Dowd, CF; Fraser, KW; Teitelbaum, GP; Hieshima, GB

Published Date

  • May 1994

Published In

Volume / Issue

  • 15 / 5

Start / End Page

  • 801 - 807

PubMed ID

  • 8059645

Pubmed Central ID

  • 8059645

International Standard Serial Number (ISSN)

  • 0195-6108

Language

  • eng

Conference Location

  • United States