Iatrogenic Sigmoid Sinus Occlusion Rescued by Graft Repair and Endovascular Thrombolysis

World Neurosurgery
Lai-Fung LiGilberto Ka-Kit Leung

Abstract

Iatrogenic cerebral venous sinus injury and occlusion may occur during resection of parasagittal meningioma and lateral skull base surgery. The former involves the superior sagittal sinus, and direct surgical repair is associated with good results. Outcome of direct repair of transverse-sigmoid sinus injury is less clear. We present a patient with iatrogenic sigmoid sinus injury in whom direct repair was complicated by subsequent thrombosis that was successfully salvaged by combined endovascular mechanical and chemical thrombolysis. A 60-year-old man with left tentorial atypical meningioma had disease recurrence after 3 excisions. Angiography revealed that the straight sinus and torcular and bilateral transverse sinuses were occluded. He underwent a fourth craniotomy with inadvertent occlusion of the transverse-sigmoid sinus junction. Direct surgical repair was done but was complicated by thrombosis. Mechanical endovenous thrombectomy was done followed by continuous urokinase infusion for 1 week. Digital subtraction angiography performed 7 days after endovascular treatment showed improved venous drainage through the left transverse-sigmoid sinus junction. The patient was ambulatory and fully independent, with no new neurologic ...Continue Reading

References

Sep 7, 1991·Lancet·K M EinhäuplP Schmiedek
Oct 1, 1971·Journal of Neurosurgery·B L Rish
Jul 21, 1999·Journal of Neurosurgery·M F PhilipsR W Hurst
Feb 20, 2003·Neurosurgery·Scott W SoleauJoel D MacDonald
Jun 2, 2005·Neurosurgical Focus·Jingjian MaHaixian Yang
Feb 5, 2011·Stroke; a Journal of Cerebral Circulation·Gustavo SaposnikUNKNOWN American Heart Association Stroke Council and the Council on Epidemiology and Prevention
Feb 19, 2017·Journal of Neurointerventional Surgery·Adeel IlyasKenneth C Liu

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