Successful treatment of cerebral venous sinus thrombosis by balloon venoplasty: a case report

Abstract

Cerebral venous sinus thrombosis is a special cerebrovascular disease affecting young adult and middle-aged people. The clinical manifestations of cerebral venous sinus thrombosis are diverse and nonspecific; thus, imaging plays an important role in early diagnosis. Anticoagulation with heparin is the preferred treatment for cerebral venous sinus thrombosis. Endovascular treatment is also being increasingly used to achieve recanalization of the cerebral venous sinus. We herein describe a woman in her early 50s who was diagnosed with cerebral venous sinus thrombosis for which anticoagulation with heparin was ineffective. To improve her symptoms and prognosis, we selected balloon venoplasty to treat the right sigmoid sinus thrombosis. Her condition subsequently improved, and no recurrence was observed after several follow-ups.

Keywords: Cerebral venous sinus thrombosis; anticoagulation with heparin; balloon venoplasty; case report; endovascular treatment; three-dimensional fast spin-echo black blood sequence.

Figure 1.

Preoperative imaging findings. (a) Preoperative axial three-dimensional fast spin-echo black blood sequence showed distinct hyperintensity in the right sigmoid sinus. (b) Preoperative magnetic resonance venography showed that the right sigmoid sinus was invisible. (c, d) Preoperative fundus examination showed obvious bilateral papilledema. (e) Preoperative digital subtraction angiography showed that the proximal right sigmoid sinus was unclear and that collateral circulation had become established (red circle) (the yellow curve indicates the normal shape of the right sigmoid sinus).

Figure 2.

Postoperative imaging findings. (a) After the operation, axial three-dimensional fast spin-echo black blood sequence showed almost complete disappearance of the abnormal high signal intensity. (b) Preoperative magnetic resonance venography showed recanalization of the right sigmoid sinus. (c, d) Postoperative fundus examination showed alleviation of the bilateral papilledema. (e) Postoperative digital subtraction angiography showed partial recovery of the right sigmoid–jugular access (red arrow).