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Treatment / Catheter-Directed Thrombolysis for Treatment of Dural Venous Sinus Thrombosis

Cerebral venous sinus thrombosis (CVST) occurs when a blood clot forms in the brain’s venous sinuses, preventing blood from draining out of the brain. As a result, blood cells may break and leak blood into the brain tissues, forming a hemorrhage. There are several types of CVST: dural venous sinus thrombosis, cortical vein thrombosis and deep cerebral vein thrombosis. Each of these can appear very similar and be difficult to distinguish via imaging. They also often exist together.

While DVST is a relatively rare condition, affecting only five people per million, it can lead to fatal consequences and is the cause of .5 to 1 percent of all strokes. Pregnant women are at greater risk because of their hypercoagulable (abnormality in blood clotting) state. Unfortunately, treating women in pregnancy can become even more complicated due to the need to weigh the risks to both mother and child.

Treatment options include:

Anticoagulation Drugs: Heparin and Warfarin are used for systemic anticoagulation, in the hopes of breaking up or reducing the clot. This is often used even when thrombolysis (surgical destruction of the clot) is anticipated.

Thrombolysis: This is a minimally invasive treatment where your neuro interventionalist will use image guidance to direct a catheter to the site of the blockage. Once the catheter is in place, a clot-dissolving medication will be delivered through the catheter over several minutes.

A cerebral venous thrombosis is a medical emergency and requires immediate care. The faster the thrombosis is treated, the better the outlook for the person. Cerebral venous thrombosis can be fatal, but it can be treated, minimizing damage and the potential for further disability.

For more information on catheter-directed treatments, please call IVC at 503-612-0498.

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