Stent treatment for cerebral venous sinus thrombosis with internal jugular vein stenosis: A case report

Abstract

A 49-year-old male was admitted to our hospital with subarachnoid hemorrhage. After clipping of right middle cerebral artery aneurysm, external and internal decompression were done for extensive brain edema. During subacute period, the bilateral parieto-temporo-occipital subcortical region showed aggravated brain edema. MR venogram revealed a left transverse and sigmoid sinus thrombosis. Systemic heparinization was started but brain edema worsened. Emergency thrombectomy was performed using balloon angioplasty and the thrombus in the sinus was completely removed. However, left internal jugular vein stenosis remained despite successive balloon dilation. Carotid Wallstent^® was placed and the patient improved dramatically. MR venogram of 28 months later showed patent stent. This is assumed to be the first case in Japan treated with stent placement for the jugular vein stenosis accompanied by cerebral venous sinus thrombosis in the literature. However, evidence of the endovascular therapeutic procedure for cerebral venous sinus thrombosis has not been established yet. We expect further studies of this treatment in this endovascular era.