Department of Radiology, 6915Mayo Clinic, Rochester, MN, USA.
Department of Neurosurgery, 6915Mayo Clinic, Rochester, MN, USA.
Neuroradiol J. 2022 Oct;35(5):654-657. doi: 10.1177/19714009221096837. Epub 2022 Apr 29.
Stenting of the intracranial venous sinuses has shown promising results in patients who are refractory to medical treatment of idiopathic intracranial hypertension (IIH). Among the reported complications associated with this procedure, in-stent thrombosis is an unreported one. We present a case of cerebral sinus thrombosis during endovascular treatment of IIH. A 33-year-old man with multiple comorbidities was presented with non-specific vision changes and headaches. Initial workup revealed a diagnosis of idiopathic intracranial hypertension which was treated medically but with no improvement. Therefore, cerebral sinus stenting was pursued. During the procedure, an in-stent thrombus was identified which was retrieved mechanically and was sent for histological and immunohistochemical evaluation. The retrieved thrombus was predominantly composed of RBCs (57.8%) followed by fibrin (30.78%), platelet (6.4%), and WBCs (5.95%), with high expression of CitH3 (neutrophil extra cellular traps specific marker) (10.9%), and CD66 (11.35%).
颅内静脉窦支架置入术在对特发性颅内高压（IIH）的药物治疗无效的患者中显示出良好的效果。在与该手术相关的已报道的并发症中，支架内血栓形成是一种未报道过的并发症。我们报告了一例在 IIH 的血管内治疗期间发生的脑窦血栓形成病例。一名 33 岁的男子患有多种合并症，表现为非特异性视力改变和头痛。初步检查诊断为特发性颅内高压，经药物治疗但无改善。因此，进行了脑窦支架置入术。在手术过程中，发现支架内有血栓形成，通过机械方法取出，并进行组织学和免疫组织化学评估。取出的血栓主要由 RBC（57.8%）组成，其次是纤维蛋白（30.78%）、血小板（6.4%）和 WBC（5.95%），CitH3（中性粒细胞细胞外陷阱特异性标志物）（10.9%）和 CD66（11.35%）表达水平高。
