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. 2004;2004(1):CD003693.
doi: 10.1002/14651858.CD003693.pub2.

Thrombolysis for cerebral vein and dural sinus thrombosis

Affiliations

Thrombolysis for cerebral vein and dural sinus thrombosis

A Ciccone et al. Cochrane Database Syst Rev. 2004.

Abstract

Background: Treatment of cerebral sinus thrombosis with thrombolytics has been reported in cases with a deteriorating clinical course despite anticoagulant therapy. The rationale of this treatment is to promote rapid recanalisation of the occluded sinus.

Objectives: To review the available evidence on the efficacy and safety of thrombolysis in confirmed cerebral sinus thrombosis.

Search strategy: We searched the Cochrane Stroke Group trials register (March 2003), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2003), MEDLINE (1966 to March 2003), EMBASE (1980 to March 2003), and reference lists of all relevant publications.

Selection criteria: We aimed to analyse separately unconfounded randomised controlled trials comparing thrombolytic agent with placebo, or thrombolytic agent with antithrombotic therapy, or thrombolytic agent and antithrombotic with antithrombotic alone, in patients with dural sinus thrombosis (confirmed by MR venography, intra-arterial venography or CT venography).

Data collection and analysis: Two groups of reviewers independently applied the inclusion criteria.

Main results: No randomised controlled trials were found.

Reviewer's conclusions: There is currently no available evidence from randomised controlled trials regarding the efficacy or safety of thrombolytic therapy in dural sinus thrombosis. A randomised controlled trial is justified to test this therapy especially in patients predicted to have a poor prognosis.

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Conflict of interest statement

None known.

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  • doi: 10.1002/14651858.CD003693

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References

References to studies excluded from this review

Wasay 2001 {published data only}
    1. Wasay M, Bakshi R, Kojan S, Bobustuc G, Dubey N, Unwin DH. Nonrandomized comparison of local urokinase thrombolysis versus systemic heparin anticoagulation for superior sagittal sinus thrombosis. Stroke 2001;32(10):2310‐7. - PubMed

Additional references

Allroggen 2000
    1. Allroggen H, Abbott RJ. Cerebral venous sinus thrombosis. Postgraduate Medical Journal 2000;76:12‐5. - PMC - PubMed
Aoki 1997
    1. Aoki N, Uchinuno H, Tanikawa T, Kagawa M, Takakura K. Superior sagittal sinus thrombosis treated with combined local thrombolytic and systemic anticoagulation therapy. Acta Neurochirurgica 1997;139:332‐5. - PubMed
Barnwell 1991
    1. Barnwell SL, Higashida RT, Halbach VV, Dowd CF, Hieshima GB. Direct endovascular thrombolytic therapy for dural sinus thrombosis. Neurosurgery 1991;28:135‐42. - PubMed
Benamer 2000
    1. Benamer HTS, Bone I. Cerebral venous thrombosis: anticoagulants or thrombolytic therapy?. Journal of Neurology Neurosurgery & Psychiatry 2000;69:427‐30. - PMC - PubMed
Bousser 1985
    1. Bousser MG, Chiras J, Bories J, Castaigne J. Cerebral venous thrombosis: a review of 38 cases. Stroke 1985;2:199‐213. - PubMed
Bousser 1999
    1. Bousser MG. Cerebral venous thrombosis: nothing, heparin, or local thrombolysis?. Stroke 1999;30:481‐3. - PubMed
Canhão 2003
    1. Canhão P, Falcão F, Ferro JM. Thrombolytics for cerebral sinus thrombosis. Cerebrovascular Diseases 2003;15:159‐66. - PubMed
Chaves 2002
    1. Chaves C, Voetsch B, Loscalzo J, Caplan L, Chavali R. Extensive cerebral venous thrombosis associated with moderate hyperhomocyst(e)inemia and successfully treated with thrombolysis. Cerebrovascular Diseases 2002;13(3):214‐6. - PubMed
Chow 2000
    1. Chow K, Gobin YP, Saver J, Kidwell C, Dong P, Viñuela F. Endovascular treatment of dural sinus thrombosis with rheolytic thrombectomy and intra‐arterial thrombolysis. Stroke 2000;3:1420‐5. - PubMed
Crassard 2003
    1. Crassard I, Canhão P, Ferro JM, Bousser MG, Barinagarrementeria F, Stam J. Neurological worsening in the acute phase of cerebral venous thrombosis in ISCVT (International Study on Cerebral Venous Thrombosis). Cerebrovascular Diseases 2003;16 Suppl 4:60.
De Asis 2002
    1. Asis Bravo F, Delgado F, Cano A, Bautista MD. Cerebral venous thrombosis: treatment with local fibrinolysis plus alteplase. Radiologia 2002;44(1):23‐6.
De Bruijn 2001
    1. Bruijn SFTM, Deveber G, Stam J. Anticoagulants for cerebral sinus thrombosis. Cochrane Database of Systematic Reviews 2001, Issue 2. [DOI: 10.1002/14651858.CD002005]
Del Rio 2001
    1. Rio Camacho G, Orozco AL, Perez‐Higueras A, Camino Lopez M, Al Assir I, Ruiz‐Moreno M. Moyamoya disease and sagittal sinus thrombosis in a child with Down's syndrome. Pediatric Radiology 2001;31(2):125‐8. - PubMed
Di Rocco 1981
    1. Rocco C, Iannelli A, Leone G, Moschini M, Valori VM. Heparin‐urokinase treatment in aseptic dural sinus thrombosis. Archives of Neurology 1981;38:431‐5. - PubMed
Ferro 2003
    1. Ferro JM, Stam J, Bousser MG, Barinagarrementeria F, Canhão P, ISCVT Collaborators. The long‐term prognosis of cerebral vein and dural sinus thrombosis: ISCVT results. Cerebrovascular Diseases 2003;16 Suppl 4:60.
Frey 1999
    1. Frey JL, Muro GJ, McDougall CG, Dean BL, Jahnke HK. Cerebral venous thrombosis: combined intrathrombus rtPA and intravenous heparin. Stroke 1999;30:489‐94. - PubMed
Funabiki 2002
    1. Funabiki Y, Fujii H, Fujitake J, Takasu K, Nishimura K, Hayakawa K, Tatsuoka Y. Four cases of cerebral venous sinus thrombosis. European Neurology 2002;48(4):228‐30. - PubMed
Higashida 1989
    1. Higashida RT, Helmer E, Halbach VV, Hieshima GB. Direct thrombolytic therapy for superior sagittal sinus thrombosis. American Journal of Neuroradiology 1989;10:S4‐S6. - PMC - PubMed
Holder 1997
    1. Holder CA, Bell DA, Lundell AL, Ulmer JL. Isolated straight sinus and deep cerebral venous thrombosis: successful treatment with local infusion of urokinase. Case report. Journal of Neurosurgery 1997;86:704‐7. - PubMed
Horowitz 1995
    1. Horowitz M, Purdy P, Unwin H, Carstens G, Greenlee R, Hise J, Kopitnik T, Batjer H, Rollins N, Samson D. Treatment of dural sinus thrombosis using selective catheterization and urokinase. Annals of Neurology 1995;38:58‐67. - PubMed
Huh 2002
    1. Huh PW, Cho KS, Yoo DS, Kim JK, Kim DS, Kang JK. Deep cerebral venous thrombosis. Acta Neurochirurgica 2002;144(1):103‐4. - PubMed
ISCVT 2003
    1. International Study on Cerebral Vein and Dural Thrombosis (ISCVT). www.iscvt.com. - PubMed
Kao 2002
    1. Kao A, Dlugos D, Hunter JV, Mamula P, Thorarensen O. Anticoagulation therapy in cerebral sinovenous thrombosis and ulcerative colitis in children. Journal of Child Neurology 2002;17(7):479‐2. - PubMed
Kermode 1995
    1. Kermode AG, Ives F, Taylor B, Davis SJ, Carroll WM. Progressive dural venous sinus thrombosis treated with local streptokinase infusion. Journal of Neurology Neurosurgery & Psychiatry 1995;58:107‐8. - PMC - PubMed
Kim 1997
    1. Kim S, Suh J. Direct endovascular thrombolytic therapy for dural sinus thrombosis: infusion of alteplase. American Journal of Neuroradiology 1997;18:639‐45. - PMC - PubMed
Ming 2002
    1. Ming S, Qi Z, Wang L, Zhu K. Deep cerebral venous thrombosis in adults. Chinese Medical Journal 2002;115(3):395‐7. - PubMed
Perez‐Duenas 2002
    1. Perez‐Duenas B, Cambra‐Lasaosa FJ, Noguera‐Julian A, Palomeque‐Rico A, Toll‐Costa T, Campistol J, et al. Cerebral venous thrombosis in a girl carrier of the prothrombin gene mutation 20210G‐‐>A treated by local fibrinolysis of the superior sagittal sinus. Revista de Neurologia 2002;35(10):913‐7. - PubMed
Persson 1990
    1. Persson L, Lilja A. Extensive dural sinus thrombosis treated by surgical removal and local streptokinase infusion. Neurosurgery 1990;26:117‐21. - PubMed
Ra 2001
    1. Ra CS, Lui CC, Liang CL, Chen HJ, Kuo YL, Chen WF. Superior sagittal sinus thrombosis induced by thyrotoxicosis. Case report. Journal of Neurosurgery 2001;94(1):130‐2. - PubMed
Rael 1997
    1. Rael JR, Orrison WW Jr, Baldwin N, Sell J. Direct thrombolysis of superior sagittal sinus thrombosis with coexisting intracranial hemorrhage. American Journal of Neuroradiology 1997;18:1238‐42. - PMC - PubMed
Renowden 1997
    1. Renowden SA, Oxbury J, Molyneux AJ. Case report: venous sinus thrombosis: the use of thrombolysis. Clinical Radiology 1997;52:396‐9. - PubMed
Smith 1994
    1. Smith T, Higashida R, Barnwell S. Treatment of dural sinus thrombosis by urokinase infusion. American Journal of Neuroradiology 1994;15:801‐7. - PMC - PubMed
Smith 1997
    1. Smith AG, Cornblath WT, Deveikis JP. Local thrombolytic therapy in deep cerebral venous thrombosis. Neurology 1997;48:1613‐9. - PubMed
Soleau 2003
    1. Soleau SW, Schmidt R, Stevens S, Osborn A, MacDonald JD, Findlay JM, et al. Extensive experience with dural sinus thrombosis. Neurosurgery 2003;52(3):534‐4. - PubMed
Stam 2003
    1. Stam J, Bruijn SFTM, DeVeber G. Anticoagulation for cerebral sinus thrombosis. Cochrane Database of Systematic Reviews 2003, Issue 1. [DOI: 10.1002/14651858.CD002005] - PubMed
Strzyzewska 2002
    1. Strzyzewska‐Lubos L, Wajgt A, Wolwender K. Cerebral venous thrombosis: a young woman case study. Neurologia i Neurochirurgia Polska 2002;36(5):993‐9. - PubMed
Tarani 2002
    1. Tarani L, Iacobini M, Stefano V, Smacchia MP, Tozzi MC, Raguso G, Bruni L. Recombinant plasminogen activator therapy for cerebral vein thrombosis in a child carrier of prothrombin gene mutation. Journal of Pediatric Hematology Oncology 2002;24(9):769‐71. - PubMed
Yang 2002
    1. Yang YH, Liu CK, Shih MC, Chou MS. Fibrin‐nonspecific agents in the direct thrombolytic treatment of venous sinus thrombosis. Quarterly Journal of Medicine 2002;95(11):763‐4. - PubMed

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