We report a young man with a history of deep coma secondary to an extensive superior sagittal sinus thrombosis despite full systemic anticoagulation. Endovascular treatment combining a 5 Max ACE reperfusion catheter (Penumbra) and Solitaire (Covidien) retrieval device permitted revascularization of the superior sagittal sinus with restoration of anterograde venous flow. This treatment led to the disappearance of cytotoxic edema on MRI and to a neurological improvement with a modified Rankin scale score of 2 after two months. Our experience shows that this technique provides a useful and safe tool after failure of anticoagulation in cerebral venous sinus thrombosis.
RaychevRTateshimaSRastogiS. Successful treatment of extensive cerebral venous sinus thrombosis using a combined approach with Penumbra aspiration system and Solitaire FR retrieval device. J Neurointerv Surg2014; 6: e32.
4.
CoutinhoJMFerroJMZuurbierSM. Thrombolysis or anticoagulation for cerebral venous thrombosis: Rationale and design of the TO-ACT trial. Int J Stroke2013; 8: 135–140.
5.
FerroJMCanhãoPStamJ. Prognosis of cerebral vein and dural sinus thrombosis: Results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke2004; 35: 664–670.
6.
SaposnikGBarinagarrementeriaFBrownRDJr. Diagnosis and management of cerebral venous thrombosis: A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke2011; 42: 1158–1192.
7.
CoutinhoJMSeeligRBousserMG. Treatment variations in cerebral venous thrombosis: An international survey. Cerebrovasc Dis2011; 32: 298–300.
8.
FerroJMCrassardICoutinhoJM. Decompressive surgery in cerebrovenous thrombosis: A multicenter registry and a systematic review of individual patient data. Stroke2011; 42: 2825–2831.
9.
DucreuxDOppenheimCVandammeX. Diffusion-weighted imaging patterns of brain damage associated with cerebral venous thrombosis. Am J Neuroradiol2001; 22: 261–268.
