Shaikh Hamza, Pukenas Bryan Anthony, McIntosh Adeka, Licht Daniel, Hurst Robert W
Department of Neuroradiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
BMJ Case Rep. 2014 Feb 19;2014:bcr2013011088. doi: 10.1136/bcr-2013-011088.
A pre-teenager with newly diagnosed ulcerative colitis presented to an emergency department with acute headache, altered mental status and bilateral lower extremity weakness. Head CT demonstrated acute thrombus in the vein of Galen and straight sinus, and the patient was started on a heparin infusion. The patient clinically deteriorated and became unresponsive. In view of the rapid deterioration despite anticoagulation therapy, the patient was taken for endovascular treatment. A novel endovascular approach was performed with combined use of Solitaire FR and Penumbra devices to enhance access to the straight sinus and to limit intraprocedural blood loss. The post-treatment head CT demonstrated a decrease in hyperattenuation within the vein of Galen and straight sinus. The neurologic status improved within 24 h. The patient was discharged home with a normal neurologic examination.
一名新诊断为溃疡性结肠炎的青少年前期患者因急性头痛、精神状态改变和双侧下肢无力就诊于急诊科。头部CT显示大脑大静脉和直窦急性血栓形成，患者开始接受肝素输注治疗。患者临床症状恶化，陷入昏迷。鉴于尽管进行了抗凝治疗但病情仍迅速恶化，患者接受了血管内治疗。采用了一种新颖的血管内治疗方法，联合使用Solitaire FR和Penumbra装置，以增加进入直窦的通路并减少术中失血。治疗后的头部CT显示大脑大静脉和直窦内的高密度影减少。神经功能状态在24小时内得到改善。患者出院时神经检查正常。
