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1.
Br J Neurosurg ; 35(3): 259-265, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32648493

RESUMEN

BACKGROUND: Cerebral venous sinus thrombosis (CVST) is a rare cerebrovascular disorder. The majority of these patients respond favorably to systemic anticoagulation. However, a subset of patients will deteriorate clinically, despite optimal medical therapy. METHODS: Retrospective single center study of 28 consecutive CVST patients treated with systemic anticoagulation and additional endovascular therapy. RESULTS: Median age was 37.5 years (range 15-76 years), there were 21 (75%) women, and 20 (71%) had thrombosis involving ≥2 venous sinuses. Intracranial hemorrhage (ICH) was present at admission in 18 patients (64%). Endovascular therapy consisted of local thrombolysis in 26 (93%) patients; 9 patients (32%) had additional mechanical thrombectomy, and in 2 (7%) patients thrombectomy alone was performed. Complete recanalization at end of the final intervention was achieved in 15 patients (54%), partial recanalization in 11 patients (39%), whereas there was no recanalization in 2 patients (7%). On follow-up imaging, conducted between 3 and 6 months, recanalization further improved to 76%, 19% and 5%, respectively. A favorable outcome (mRS ≤ 2) was achieved in 63% of patients at 3 months, which improved to 79% at 6 months. Post-procedural ICH or volume expansion of preexisting ICH was seen in 9 patients (32%). In total 5 patients died (18%). CONCLUSIONS: Systemic anticoagulation with the addition of endovascular therapy with local thrombolysis and/or mechanical thrombectomy is a potential strategy to obtain recanalization in patients with CVST who deteriorate clinically despite medical therapy or are comatose. Endovascular therapy may increase the risk of ICH.


Asunto(s)
Procedimientos Endovasculares , Trombosis de los Senos Intracraneales , Adolescente , Adulto , Anciano , Senos Craneales , Femenino , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Trombosis de los Senos Intracraneales/diagnóstico por imagen , Trombosis de los Senos Intracraneales/tratamiento farmacológico , Trombectomía , Terapia Trombolítica , Resultado del Tratamiento , Adulto Joven
2.
Ugeskr Laeger ; 180(35)2018 Aug 27.
Artículo en Danés | MEDLINE | ID: mdl-30152324

RESUMEN

The goal when treating ischaemic apoplexy is a rapid, safe and effective recanalization. For some years, the main treatment has been the administration of IV thrombolysis, but due to several restrictions, lack of efficacy and a limited window of opportunity for treatment, an alternative method was needed. This formed the foundation for the develop-ment of endovascular thrombectomy. This review describes the development and the mechanisms involved as well as the results and treatment gains.


Asunto(s)
Isquemia Encefálica/terapia , Procedimientos Endovasculares/métodos , Accidente Cerebrovascular/terapia , Trombectomía/métodos , Dinamarca , Humanos , Tiempo de Tratamiento , Resultado del Tratamiento
3.
Ugeskr Laeger ; 176(45)2014 Nov 03.
Artículo en Danés | MEDLINE | ID: mdl-25394840

RESUMEN

Cerebral aneurysm following a cardiac myxoma is a rare neurological complication. We report a 50-year-old man who developed cerebral aneurysms one year after resection of a cardiac myxoma. Magnetic resonance imaging of the brain showed features of intracranial haemorrhage. Digital subtraction angiography showed several fusiform intracranial aneurysms bilaterally in the middle cerebral artery. Finally, we discuss potential molecular mechanisms of the development of myxomatous aneurysms.


Asunto(s)
Neoplasias Cardíacas/complicaciones , Aneurisma Intracraneal/etiología , Mixoma/complicaciones , Angiografía de Substracción Digital , Angiografía Cerebral , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/cirugía , Humanos , Aneurisma Intracraneal/diagnóstico por imagen , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Mixoma/diagnóstico por imagen , Mixoma/cirugía
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