Background: Dural sinus thrombosis is a relatively rare syndrome, often with a very poor prognosis. Systemic anticoagulant therapy has produced poor results; therefore rapid recanalization of the affected vessels is essential. The recent advancements in angiographic technique and catheter technology enable us to perform direct selective venography.
Case report: We observed a case of acute superior sagittal sinus thrombosis in a pregnant woman. The patient's consciousness level and motor function gradually deteriorated. Direct thrombolysis was performed via venography.
Results: The patient was treated successfully by thrombolysis with infusion of t-PA via selective venography within 2 days of rapid clinical deterioration and sustained a dramatic improvement of her neurological deficits.
Conclusions: Direct thrombolysis via selective venography is considered a safe and useful treatment for dural sinus thrombosis in the acute phase.