Good clinical outcome after combined endovascular and neurosurgical treatment of cerebral venous sinus thrombosis.

Abstract

INTRODUCTION: A subgroup of patients suffering from cerebral venous sinus thrombosis (CVST) has a poor prognosis with standard anticoagulant treatment alone. Over a five-year period, we treated nine patients with aggressive endovascular therapy and neurosurgical/neurointensive treatment. In this study, the effect of this treatment is evaluated. MATERIAL AND METHODS: A retrospective analysis of electronic patient files and data was performed. RESULTS: All treated patients had partial or complete recanalization of the affected sinus after endovascular treatment. In three patients, a decompressive craniectomy was performed due to elevated intracranial pressure. Eight patients out of nine achieved a good outcome at follow-up (modified Rankin Scale 0-2). One patient died. No patients experienced recurrence of CVST. CONCLUSION: Aggressive combined endovascular and neurosurgical treatment of patients with severe CVST is associated with a good clinical outcome in the cases in which the patient's clinical condition deteriorates despite standard anticoagulation therapy. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.