Majoie C B, van Delden O M, Sluzewski M, Nijssen P C, Stam J, Reekers J A
Afd. Radiologie, Academisch Medisch Centrum/Universiteit van Amsterdam.
Ned Tijdschr Geneeskd. 2000 Sep 16;144(38):1839-44.
Two patients with cerebral sinus thrombosis were successfully treated with neuroradiological intervention procedures, one with local thrombolysis and the other with mechanical thrombosuction using a hydrolyser catheter. The first patient, a 20-year-old woman, was treated with asparaginase for acute lymphatic leukaemia. She lapsed into coma with extensor posturing due to superior sagittal and right transverse sinus thrombosis. She recovered completely after local thrombolysis with 2,940,000 units urokinase, administered over a period of 40 hours. The second patient was a 29-year-old man who presented with clinical deterioration after seizures due to superior sagittal, left transverse and straight sinus thrombosis. A CT-scan demonstrated bilateral haemorrhagic cerebral infarctions. Since the risk of haemorrhage during thrombolysis with urokinase was considered to be high, mechanical thrombosuction with a hydrolyser catheter was performed. This procedure took only 4 hours. The patient recovered completely in two weeks. These cases add further evidence to the effectiveness of thrombolysis and thrombosuction in selected patients with severe cerebral sinus thrombosis.
两名脑静脉窦血栓形成患者通过神经放射介入程序成功治疗,其中一名接受局部溶栓治疗,另一名使用水解器导管进行机械血栓抽吸。第一名患者是一名20岁女性,因急性淋巴细胞白血病接受天冬酰胺酶治疗。她因上矢状窦和右侧横窦血栓形成陷入昏迷并出现伸肌姿势。在40小时内给予2940000单位尿激酶进行局部溶栓后,她完全康复。第二名患者是一名29岁男性,因上矢状窦、左侧横窦和直窦血栓形成发作后出现临床恶化。CT扫描显示双侧出血性脑梗死。由于认为尿激酶溶栓期间出血风险较高,因此使用水解器导管进行机械血栓抽吸。该手术仅耗时4小时。患者在两周内完全康复。这些病例进一步证明了溶栓和血栓抽吸对选定的严重脑静脉窦血栓形成患者的有效性。