Huber R, Gdynia H-J, Kühnlein P, Schmitz B
Neurologische Klinik der Universität Ulm im Rehabilitationskrankenhaus Ulm, Oberer Eselsberg 45, Ulm, Germany.
Nervenarzt. 2007 Dec;78(12):1430-4. doi: 10.1007/s00115-007-2299-8.
Acute cerebral vein and dural sinus thrombosis are usually treated with unfractionated intravenous heparin. Progression of symptoms after appropriate heparin dosage appears to be a rare event. In the literature only single case reports or small case series dealing with local intravenous fibrinolysis are available. Here we describe a 44-year-old woman with progressive thrombosis of the sinus rectus and right sinus transversus upon an appropriate dosage of heparin who was successfully treated with urokinase 12 h after symptom onset. This case demonstrates that local thrombolysis should be discussed in patients with progression of the clinical or radiological picture under sufficient heparin therapy.
急性脑静脉和硬脑膜窦血栓形成通常采用静脉注射普通肝素进行治疗。在给予适当剂量肝素后症状仍进展似乎是罕见事件。文献中仅有关于局部静脉溶栓的单例报告或小病例系列。在此，我们描述一名44岁女性，在给予适当剂量肝素后，直窦和右侧横窦出现进行性血栓形成，在症状发作后12小时用尿激酶成功治疗。该病例表明，对于在充分肝素治疗下临床或影像学表现仍进展的患者，应考虑局部溶栓治疗。
