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Surgical Superior Sagittal Sinus Thrombectomy in Refractory Thrombosis: A Technical Note
Harrison J Westwick1, Sami Obaid1, Frederique Bordeleau-Roy2
1Division of Pediatric Neurosurgery, Department of Surgery, Sainte Justine Hospital, University of Montreal, Montreal, Québec, Canada.
Pediatric Neurosurgery
|March 21, 2019
Summary
Direct surgical sinus thrombectomy offers a feasible treatment for pediatric cerebral venous sinus thrombosis (CVT) refractory to other therapies, improving outcomes.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Pediatric Critical Care
Background:
- Cerebral venous sinus thrombosis (CVT) can be challenging to treat.
- Limited surgical options exist for refractory cases, especially in pediatric patients.
Purpose of the Study:
- To describe the technical feasibility of open, direct sinus thrombectomy.
- To evaluate this approach in a pediatric patient with refractory CVT.
Main Methods:
- A 15-year-old patient with superior sagittal sinus (SSS) thrombosis refractory to medical and endovascular treatments underwent surgery.
- Surgical intervention included decompressive hemicraniectomy and burr hole SSS thrombectomy with Fogarty balloon and direct tissue plasminogen activator injection.
Main Results:
- Direct sinus thrombectomy was technically feasible.
- Excellent intracranial pressure control and radiological recanalization of the SSS were achieved.
- The patient experienced a good clinical outcome.
Conclusions:
- Direct surgical sinus thrombectomy is a viable treatment option.
- It can be used adjunctively with decompressive craniectomy for refractory pediatric CVT.
Keywords:
Cerebral venous sinus thrombosisDecompressive craniotomyNeurosurgerySuperior sagittal sinusThrombectomyMore Related Videos
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