Article Text

other Versions

PDF
Case series
Management and outcome of spontaneous cerebral venous sinus thrombosis in a 5-year consecutive single-institution cohort
  1. Darrin J Lee1,
  2. Arjang Ahmadpour1,
  3. Tamar Binyamin1,
  4. Brian C Dahlin2,
  5. Kiarash Shahlaie1,
  6. Ben Waldau1
  1. 1Department of Neurological Surgery, University of California-Davis Medical Center, Sacramento, California, USA
  2. 2Department of Radiology, University of California-Davis Medical Center, Sacramento, California, USA
  1. Correspondence to Professor Ben Waldau, Department of Neurological Surgery, University of California, Davis School of Medicine, 4860 Y Street, Suite 3740, Sacramento, CA 95817, USA; bwaldau{at}ucdavis.edu

Abstract

Cerebral venous sinus thrombosis (CVST) is an uncommon form of stroke with a variable presentation, ranging from headaches, to coma and death. Although the American Stroke Association has developed guidelines for the treatment of CVST, data are sparse on the outcome after treatment with anticoagulation, thrombolysis, and thrombectomy. In this retrospective review, we describe the 5-year UC Davis experience with spontaneous CVST. Forty-one patients (mean age 37.5±23.1, range 0–96 years; 29 female) were identified with CVST. The majority of cases involved the transverse sinus (75.6%), sigmoid sinus (58.5%), and superior sagittal sinus (29.3%). The most common form of treatment was anticoagulation or antiplatelet therapy (n=35), while six patients were managed by observation alone. The overall 1-year modified Rankin score (mRS) was 1.4±1.5. Male patients and patients with a poor admission mRS had a worse outcome. Outcome was unaffected by hypercoagulable state, number of dural sinuses involved, the presence of intracranial hemorrhage, or seizures. Two patients who underwent anticoagulation therapy also required endovascular thrombectomy; both patients had a 1-year mRS of ≤2. Two patients underwent direct open surgical canalization of the superior sagittal sinus with varying outcomes (mRS 2 vs mRS 6). In our series, the majority (92.9%) of patients with spontaneous dural sinus thrombosis had a favorable clinical outcome as defined by a mRS ≤2. Further prospective studies are needed to study the impact of anticoagulation on the clinical course of the disease.

  • Thrombectomy
  • Thrombolysis

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.