Isolated deep cerebral venous thrombosis treated by direct endovascular thrombolysis

Surg Neurol. 1997 Sep;48(3):261-6. doi: 10.1016/s0090-3019(96)00554-x.


Background: Isolated thrombosis of the deep cerebral venous system is very rare and is associated with a poor prognosis. Antithrombin III (AT III) deficiency is a disorder of hypercoagulability associated with deep venous thrombosis and recurrent pulmonary emboli. We report a case of an 18-year-old man who presented with spontaneous thrombosis of the deep cerebral veins and straight dural sinus as the initial presentation of a previously undiagnosed AT III deficiency.

Methods: The patient was managed using direct endovascular infusion of the fibrinolytic agent urokinase followed by intravenous heparin.

Results: The technique was successful in establishing patency of the deep cerebral venous system. The patient experienced a good clinical outcome.

Conclusions: Direct endovascular thrombolysis is a potentially effective management strategy for isolated thrombosis of the deep cerebral venous system.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antithrombin III Deficiency*
  • Blood Coagulation Disorders / complications
  • Blood Coagulation Disorders / diagnosis*
  • Cerebral Veins
  • Diagnosis, Differential
  • Humans
  • Intracranial Embolism and Thrombosis / drug therapy*
  • Intracranial Embolism and Thrombosis / etiology
  • Magnetic Resonance Angiography
  • Magnetic Resonance Imaging
  • Male
  • Plasminogen Activators / therapeutic use*
  • Sinus Thrombosis, Intracranial / drug therapy
  • Thrombolytic Therapy* / methods
  • Tomography, X-Ray Computed
  • Urokinase-Type Plasminogen Activator / therapeutic use*


  • Plasminogen Activators
  • Urokinase-Type Plasminogen Activator