• A Ciccone, P Canhão, F Falcão, J M Ferro, and R Sterzi.
• Stroke Unit, Department of Neurosciences, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, Milano, Italy.
• Cochrane Db Syst Rev. 2004 Jan 1; 2004 (1): CD003693CD003693.

BackgroundTreatment of cerebral sinus thrombosis with thrombolytics has been reported in cases with a deteriorating clinical course despite anticoagulant therapy. The rationale of this treatment is to promote rapid recanalisation of the occluded sinus.ObjectivesTo review the available evidence on the efficacy and safety of thrombolysis in confirmed cerebral sinus thrombosis.Search StrategyWe searched the Cochrane Stroke Group trials register (March 2003), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2003), MEDLINE (1966 to March 2003), EMBASE (1980 to March 2003), and reference lists of all relevant publications.Selection CriteriaWe aimed to analyse separately unconfounded randomised controlled trials comparing thrombolytic agent with placebo, or thrombolytic agent with antithrombotic therapy, or thrombolytic agent and antithrombotic with antithrombotic alone, in patients with dural sinus thrombosis (confirmed by MR venography, intra-arterial venography or CT venography).Data Collection And AnalysisTwo groups of reviewers independently applied the inclusion criteria.Main ResultsNo randomised controlled trials were found.Reviewer's ConclusionsThere is currently no available evidence from randomised controlled trials regarding the efficacy or safety of thrombolytic therapy in dural sinus thrombosis. A randomised controlled trial is justified to test this therapy especially in patients predicted to have a poor prognosis.

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