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P038 Deep venous thrombosis with internal cerebral vein recanalization
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  1. Antonio MacEra1,
  2. Amedeo Cervo1,
  3. Claudia Rollo1,
  4. Ghil Schwartz2,
  5. Guglielmo Pero1,
  6. Mariangela Piano1
  1. 1Department of Neuroradiology, Ospedale Niguarda Ca’ Granda, Milan, Italy
  2. 2Department of Neurology Ospedale Niguarda Ca’ Granda, Milan, Italy

Abstract

Introduction Cerebral venous thrombosis (CVT) is a rare cause of stroke that tends to affect young people. Endovascular treatment (EVT) has not yet shown to be beneficial in CVT and is therefore actually only indicated as rescue therapy in severe and refractory cases for medical treatment. Deep venous system thrombosis could represent a life treating condition. EVT in these specific cases could represent a life saving procedure and the indication could be stronger than other thrombosis locations.

Case Description We report a case of a 84 years old lady with no significant clinical history, who suffered from sudden onset of confusion, aphasia and right sensitive and motor hemysindrome, scoring 12 of NIHSS. The CT Angio demostred a left transverse and straight sinus and left internal cerebral vein thrombosis with left thalamus hypodensity. The decision, taken together with the neurologist, was to start systemic anticoagulation and to perform EVT with the aim of recanalizing the occluded sinuses and the left cerebral internal vein. The days after the patient partially recovered and was discharged with a mRS of 3 and a NIHSS of 6.

Results EVT in CVT has several potential benefit in selected cases at high risk of morbidity and mortality, especially when the deep venous system is involved. Along with the improvement in endovascular techniques, more studies and randomized controlled trials are required to better define patient selection and outcomes.

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