• P C Gerszten, W C Welch, M P Spearman, C A Jungreis, and R L Redner.
• Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pennsylvania, USA.
• Surg Neurol. 1997 Sep 1; 48 (3): 261-6.

BackgroundIsolated thrombosis of the deep cerebral venous system is very rare and is associated with a poor prognosis. Antithrombin III (AT III) deficiency is a disorder of hypercoagulability associated with deep venous thrombosis and recurrent pulmonary emboli. We report a case of an 18-year-old man who presented with spontaneous thrombosis of the deep cerebral veins and straight dural sinus as the initial presentation of a previously undiagnosed AT III deficiency.MethodsThe patient was managed using direct endovascular infusion of the fibrinolytic agent urokinase followed by intravenous heparin.ResultsThe technique was successful in establishing patency of the deep cerebral venous system. The patient experienced a good clinical outcome.ConclusionsDirect endovascular thrombolysis is a potentially effective management strategy for isolated thrombosis of the deep cerebral venous system.

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