{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T20:25:30Z","timestamp":1772915130501,"version":"3.50.1"},"reference-count":42,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1999,1]]},"abstract":"Object.<\/jats:italic> The authors sought to treat potentially catastrophic intracranial dural and deep cerebral venous thrombosis by using a multimodality endovascular approach.<\/jats:p>Methods.<\/jats:italic> Six patients aged 14 to 75 years presented with progressive symptoms of thrombotic intracranial venous occlusion. Five presented with neurological deficits, and one patient had a progressive and intractable headache. All six had known risk factors for venous thrombosis: inflammatory bowel disease (two patients), nephrotic syndrome (one), cancer (one), use of oral contraceptive pills (one), and puerperium (one). Four had combined dural and deep venous thrombosis, whereas clot formation was limited to the dural venous sinuses in two patients. All patients underwent diagnostic cerebral arteriograms followed by transvenous catheterization and selective sinus and deep venous microcatheterization. Urokinase was delivered at the proximal aspect of the thrombus in dosages of 200,000 to 1,000,000 IU. In two patients with thrombus refractory to pharmacological thrombolytic treatment, mechanical wire microsnare maceration of the thrombus resulted in sinus patency. Radiological studies obtained 24 hours after thrombolysis reconfirmed sinus\/vein patency in all patients. All patients' symptoms and neurological deficits improved, and no procedural complications ensued. Follow-up periods ranged from 12 to 35 months, and all six patients remain free of any symptomatic venous reocclusion. Factors including patients' age, preexisting medical conditions, and duration of symptoms had no statistical bearing on the outcome.<\/jats:p>Conclusions.<\/jats:italic> Patients with both dural and deep cerebral venous thrombosis often have a variable clinical course and an unpredictable neurological outcome. With recent improvements in interventional techniques, endovascular therapy is warranted in symptomatic patients early in the disease course, prior to morbid and potentially fatal neurological deterioration.<\/jats:p>","DOI":"10.3171\/jns.1999.90.1.0065","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T17:26:30Z","timestamp":1242235590000},"page":"65-71","source":"Crossref","is-referenced-by-count":92,"title":["Endovascular thrombolysis for symptomatic cerebral venous thrombosis"],"prefix":"10.3171","volume":"90","author":[{"given":"Matthew F.","family":"Philips","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda J.","family":"Bagley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grant P.","family":"Sinson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric C.","family":"Raps","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven L.","family":"Galetta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric L.","family":"Zager","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert W.","family":"Hurst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Neurol Clin","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/S0733-8619(18)30235-4","article-title":"Cerebral venous thrombosis.","volume":"10","author":"Ameri","year":"1992"},{"key":"b2","series-title":"AJR","doi-asserted-by":"publisher","first-page":"784","DOI":"10.2214\/ajr.170.3.9490974","article-title":"Use of a microsnare to aid direct thrombolytic therapy of dural sinus thrombosis.","volume":"170","author":"Bagley","year":"1998"},{"key":"b3","series-title":"AJNR","first-page":"1817","article-title":"Safety and efficacy of delayed intraarterial urokinase therapy with mechanical clot disruption for thromboembolic stroke.","volume":"15","author":"Barnwell","year":"1994"},{"key":"b4","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1227\/00006123-199101000-00019","article-title":"Direct endovascular thrombolytic therapy for dural sinus thrombosis.","volume":"28","author":"Barnwell","year":"1991"},{"key":"b5","series-title":"Kidney Int","doi-asserted-by":"publisher","first-page":"1401","DOI":"10.1038\/ki.1994.183","article-title":"Mechanical versus pharmacomechanical thrombolysis for the treatment of thrombosed dialysis access grafts.","volume":"45","author":"Beathard","year":"1994"},{"key":"b6","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1161\/01.STR.16.2.199","article-title":"Cerebral venous thrombosis\u2014a review of 38 cases.","volume":"16","author":"Bousser","year":"1985"},{"key":"b7","series-title":"Neurosurgery","first-page":"911","article-title":"Deep cerebral venous system thrombosis: case report.","volume":"33","author":"Brown","year":"1993"},{"key":"b8","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1880","DOI":"10.1161\/01.STR.24.12.1880","article-title":"Cerebral venous thrombosis associated with pregnancy and puerperium. 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