Mechanical Thrombectomy as an Initial Treatment for Sinus Thrombosis

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Objective: Sinus thrombosis often deteriorates despite anticoagulation therapy. Early endovascular therapy may lead to a better outcome in such cases. We report a case of sinus thrombosis treated by mechanical thrombectomy as an initial treatment.

Case Presentation: A 45-year-old female presented with headache and tonic seizure affecting the right arm. Computed tomography revealed subcortical hemorrhage at the right superior frontal gyrus. Occlusion of the superior sagittal sinus (SSS) was found on CTA and we diagnosed sinus thrombosis. Digital subtraction angiography demonstrated complete occlusion of the SSS and venous congestion at the middle third of the SSS. Immediately after diagnosis, we performed mechanical thrombectomy as an initial treatment. Partial recanalization was achieved after mechanical thrombectomy. Postoperative anticoagulation therapy was continued, and her symptom was improved.

Conclusion: Mechanical thrombectomy as an initial treatment for sinus thrombosis may be a useful treatment option when aggravation of the symptoms is predicted.