PMID- 27570379
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160829
LR  - 20200930
IS  - 0972-2327 (Print)
IS  - 1998-3549 (Electronic)
IS  - 0972-2327 (Linking)
VI  - 19
IP  - 3
DP  - 2016 Jul-Sep
TI  - Intrasinus thrombolysis in cerebral venous sinus thrombosis: Experience from a 
      university hospital, India.
PG  - 307-11
LID - 10.4103/0972-2327.186785 [doi]
AB  - BACKGROUND: Intrasinus thrombolysis (IST) is believed to improve outcome in 
      patients of cerebral venous sinus thrombosis (CVST) unresponsive to heparin. 
      PURPOSE: The purpose of this article is to describe our experience with IST in 
      patients of CVST unresponsive to heparin. MATERIALS AND METHODS: Hospital 
      databases were searched, and patients with CVST who underwent IST from May 2011 
      to March 2014 were identified. Data on clinical presentation, duration of 
      symptoms, and indications and dosage of IST were retrieved and outcomes analyzed. 
      RESULTS: Twenty-four patients received IST. The presenting symptoms included 
      headache (n = 19), seizures (n = 16), and altered sensorium (n = 14); signs 
      included papilledema (n = 20) and hemiparesis (n = 15). Nineteen patients 
      received unfractionated heparin (UFH), four received low-molecular-weight heparin 
      (LMWH), and one received both. In one patient, microcatheter could not be passed, 
      two patients bled intracranially, and three had nonintracranial bleeds. Among 
      four deaths, none was due to iatrogenic bleeding. On discharge, 10 patients 
      (43.5%) had good improvement with the modified Rankin Scale (score; mRS) </=2 and 
      eight (34.8%) had partial improvement with mRS = 3, 4. Seventeen patients (73.9%) 
      had mRS </=2 at 6 months follow-up. Bleeding complications of urokinase were less 
      than those of alteplase. Recanalization of the involved sinuses was achieved in 
      all. Early intervention led to successful recanalization. Functional 
      recanalization decreased intracranial bleeding. CONCLUSION: Till date, our study 
      is the largest series of IST in CVST reported from India. IST may be more 
      effective than systemic heparin anticoagulation in moribund and unresponsive 
      patients despite the potential for bleeding manifestations. Functional 
      recanalization is adequate for good results. However, a randomized prospective 
      study comparing heparin anticoagulation with IST is warranted.
FAU - Mathukumalli, Neeharika L
AU  - Mathukumalli NL
AD  - Department of Neurology, Nizam's Institute of Medical Sciences (NIMS), Hyderabad, 
      Telangana, India.
FAU - Susarla, Ram Murti
AU  - Susarla RM
AD  - Department of Radiology, Nizam's Institute of Medical Sciences (NIMS), Hyderabad, 
      Telangana, India.
FAU - Kandadai, Mridula R
AU  - Kandadai MR
AD  - Department of Neurology, Nizam's Institute of Medical Sciences (NIMS), Hyderabad, 
      Telangana, India.
FAU - Turaga, Suryaprabha
AU  - Turaga S
AD  - Department of Neurology, Nizam's Institute of Medical Sciences (NIMS), Hyderabad, 
      Telangana, India.
FAU - Shaik, Jabeen A
AU  - Shaik JA
AD  - Department of Neurology, Nizam's Institute of Medical Sciences (NIMS), Hyderabad, 
      Telangana, India.
FAU - Alladi, Suvarna
AU  - Alladi S
AD  - Department of Neurology, Nizam's Institute of Medical Sciences (NIMS), Hyderabad, 
      Telangana, India.
FAU - Kanikannan, Meena A
AU  - Kanikannan MA
AD  - Department of Neurology, Nizam's Institute of Medical Sciences (NIMS), Hyderabad, 
      Telangana, India.
FAU - Borgohain, Rupam
AU  - Borgohain R
AD  - Department of Neurology, Nizam's Institute of Medical Sciences (NIMS), Hyderabad, 
      Telangana, India.
FAU - Kaul, Subhash
AU  - Kaul S
AD  - Department of Neurology, Nizam's Institute of Medical Sciences (NIMS), Hyderabad, 
      Telangana, India.
LA  - eng
PT  - Journal Article
PL  - India
TA  - Ann Indian Acad Neurol
JT  - Annals of Indian Academy of Neurology
JID - 101273955
PMC - PMC4980950
OTO - NOTNLM
OT  - Cerebral venous sinus thrombosis (CVST)
OT  - intrasinus thrombolysis (IST)
OT  - outcome
EDAT- 2016/08/30 06:00
MHDA- 2016/08/30 06:01
PMCR- 2016/07/01
CRDT- 2016/08/30 06:00
PHST- 2016/08/30 06:00 [entrez]
PHST- 2016/08/30 06:00 [pubmed]
PHST- 2016/08/30 06:01 [medline]
PHST- 2016/07/01 00:00 [pmc-release]
AID - AIAN-19-307 [pii]
AID - 10.4103/0972-2327.186785 [doi]
PST - ppublish
SO  - Ann Indian Acad Neurol. 2016 Jul-Sep;19(3):307-11. doi: 10.4103/0972-2327.186785.