Format

Send to

Choose Destination
Neurosurg Focus. 2009 Jun;26(6):E5. doi: 10.3171/2009.3.FOCUS0910.

Decompressive surgery in malignant dural sinus thrombosis: report of 3 cases and review of the literature.

Author information

1
Department of Neuroscience and Surgery of the Nervous System, Ospedali Riuniti, Bergamo, Italy. l.lanterna@virgilio.it

Abstract

Cerebral venous and dural sinus thrombosis (CVDST) is a rare cause of stroke in young and middle-aged adults. When the clinical course is complicated by uncontrollable intracranial hypertension and brainstem compression due to edema or cerebral hemorrhage, the prognosis is poor. The authors evaluated the therapeutic role of surgical decompression in patients with clinical signs of impending herniation. Cerebral venous and dural sinus thrombosis complicated by impending brain herniation a very rare, life-threatening but potentially treatable clinical condition. Three patients with pupillary signs of transtentorial herniation due to brain edema and hemorrhage caused by CVDST (superior sagittal sinus in 1 patient and transverse and sigmoid sinus in 2 patients) were treated surgically. The intervention consisted of clot removal, infarcted tissue resection, and frontotemporoparietooccipital craniectomy with duraplasty. According to the Glasgow Outcome Scale, 2 patients were classified as having good recovery and 1, moderate disability. The results of neuropsychological assessment were normal in 2 patients and demonstrated a partial neuropsychological deficit (neglect) in the other. Surgery may be indicated in selected patients with CVDST whose condition is deteriorating because of intractable intracranial hypertension and impending brain herniation.

PMID:
19485718
DOI:
10.3171/2009.3.FOCUS0910
[Indexed for MEDLINE]

Supplemental Content

Loading ...
Support Center