Cellerini Martino, Francavilla Rosa, Testoni Caterina, Maffei Monica, Zucchelli Mino, Ghizzi Chiara
Department of Neuroradiology, ISNB - IRCCS, Bologna, Emilia-Romagna, Italy.
Department of Pediatrics, Maggiore Hospital, ISNB - IRCCS, Bologna, Emilia-Romagna, Italy.
Surg Neurol Int. 2020 Aug 21;11:253. doi: 10.25259/SNI_236_2020. eCollection 2020.
Children with intracranial hypertension are at risk for visual loss and their visual function must be closely monitored. Surgery with the insertion of a ventriculoperitoneal shunt is imperative when vision is threatened.
Herein, we report a case of a 5-year-old boy whose refractory intracranial hypertension and severe, progressive visual loss (secondary to a chronic, otogenic, right sigmoid sinus thrombosis, and a contralateral sinus tight stenosis) were resolved by a combination of continuous (6 h), locoregional, infusion of recombinant tissue plasminogen activator (rt-PA), and mechanical thrombectomy.
The association of in loco and continuous infusion of recombinant tissue plasminogen activator (rt- PA) with mechanical thrombectomy resulted in effective in partially reopening the occluded sinus and facilitating a good clinical recovery. This combined endovascular approach may represent an alternative, less invasive, therapeutic option to surgery in children with intracranial hypertension caused by chronic cerebral venous sinus thrombosis.
颅内高压患儿有视力丧失的风险，必须密切监测其视觉功能。当视力受到威胁时，插入脑室腹腔分流管的手术势在必行。
在此，我们报告一例5岁男孩，其难治性颅内高压和严重的进行性视力丧失（继发于慢性耳源性右乙状窦血栓形成和对侧窦严重狭窄）通过连续（6小时）局部注射重组组织型纤溶酶原激活剂（rt-PA）和机械取栓术相结合得以解决。
局部连续输注重组组织型纤溶酶原激活剂（rt-PA）与机械取栓术相结合有效地部分重新开通了闭塞的窦，并促进了良好的临床恢复。这种联合血管内治疗方法可能是慢性脑静脉窦血栓形成所致颅内高压患儿手术的一种替代的、侵入性较小的治疗选择。
