Neurological recovery after coma related to diffuse cerebral venous sinus thrombosis. Interest in thrombi-aspiration with Penumbra system

Interv Neuroradiol. 2015 Apr;21(2):218-21. doi: 10.1177/1591019915582000. Epub 2015 May 5.

Abstract

We report a young man with a history of deep coma secondary to an extensive superior sagittal sinus thrombosis despite full systemic anticoagulation. Endovascular treatment combining a 5 Max ACE reperfusion catheter (Penumbra) and Solitaire (Covidien) retrieval device permitted revascularization of the superior sagittal sinus with restoration of anterograde venous flow. This treatment led to the disappearance of cytotoxic edema on MRI and to a neurological improvement with a modified Rankin scale score of 2 after two months. Our experience shows that this technique provides a useful and safe tool after failure of anticoagulation in cerebral venous sinus thrombosis.

Keywords: Cerebral venous sinus thrombosis; aspiration catheter; endovascular treatment; thrombi-aspiration.

Publication types

  • Case Reports

MeSH terms

  • Anticoagulants / therapeutic use
  • Brain Edema / diagnostic imaging
  • Brain Edema / therapy
  • Cerebral Angiography
  • Coma / diagnostic imaging
  • Coma / etiology*
  • Coma / therapy*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Recovery of Function
  • Sinus Thrombosis, Intracranial / complications
  • Sinus Thrombosis, Intracranial / diagnostic imaging
  • Sinus Thrombosis, Intracranial / therapy*
  • Thrombectomy / instrumentation
  • Thrombectomy / methods*

Substances

  • Anticoagulants