Bilateral Decompressive Craniectomy in Malignant Cerebral Venous Thrombosis
Introduction: Despite the extremely favourable prognosis of patients with cerebral venous thrombosis (CVT), death occurs in 10–15% of patients. In severe cases of malignant CVT with supratentorial haemorrhagic lesions, cerebral oedema and brain herniation, decompressive surgery may be the only life-...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SMC MEDIA SRL
2020-04-01
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| Series: | European Journal of Case Reports in Internal Medicine |
| Subjects: | |
| Online Access: | https://www.ejcrim.com/index.php/EJCRIM/article/view/1560 |
| _version_ | 1811223021473497088 |
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| author | Eduardo Soriano-Navarro Vanessa Cano-Nigenda Fernanda Menéndez-Manjarrez Esmirna Farington-Terrero Juan José Méndez-Gallardo Alejandro García-Irigoyen Antonio Arauz |
| author_facet | Eduardo Soriano-Navarro Vanessa Cano-Nigenda Fernanda Menéndez-Manjarrez Esmirna Farington-Terrero Juan José Méndez-Gallardo Alejandro García-Irigoyen Antonio Arauz |
| author_sort | Eduardo Soriano-Navarro |
| collection | DOAJ |
| description | Introduction: Despite the extremely favourable prognosis of patients with cerebral venous thrombosis (CVT), death occurs in 10–15% of patients. In severe cases of malignant CVT with supratentorial haemorrhagic lesions, cerebral oedema and brain herniation, decompressive surgery may be the only life-saving treatment.
Patient and methods: We present the case of a puerperal young woman with progressive headache, seizures and decreased alertness. Thrombosis of the entire superior sagittal sinus with bifrontal venous infarcts and midline shift was confirmed by magnetic resonance imaging with venography sequencing. Despite medical treatment with anticoagulation, progressive neurological deterioration was observed, so bilateral, frontal decompressive craniectomy was performed.
Results: At the 6-month follow-up, we observed partial functional recovery with a modified Rankin score of 3.
Discussion: Bilateral decompressive craniectomy may be a life-saving therapeutic option when medical therapy fails and there are clinical and radiological features of progression in both cerebral hemispheres. |
| first_indexed | 2024-04-12T08:25:45Z |
| format | Article |
| id | doaj.art-c8bcf40b4b1e48ef92ca97001802b0e6 |
| institution | Directory Open Access Journal |
| issn | 2284-2594 |
| language | English |
| last_indexed | 2024-04-12T08:25:45Z |
| publishDate | 2020-04-01 |
| publisher | SMC MEDIA SRL |
| record_format | Article |
| series | European Journal of Case Reports in Internal Medicine |
| spelling | doaj.art-c8bcf40b4b1e48ef92ca97001802b0e62022-12-22T03:40:24ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942020-04-0110.12890/2020_0015601207Bilateral Decompressive Craniectomy in Malignant Cerebral Venous ThrombosisEduardo Soriano-Navarro0Vanessa Cano-Nigenda1Fernanda Menéndez-Manjarrez2Esmirna Farington-Terrero3Juan José Méndez-Gallardo4Alejandro García-Irigoyen5Antonio Arauz6Stroke Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, MexicoStroke Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, MexicoStroke Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco SuárezStroke Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, MexicoStroke Clinic, Endovascular Stroke Therapy, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, MexicoStroke Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, MexicoStroke Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, MexicoIntroduction: Despite the extremely favourable prognosis of patients with cerebral venous thrombosis (CVT), death occurs in 10–15% of patients. In severe cases of malignant CVT with supratentorial haemorrhagic lesions, cerebral oedema and brain herniation, decompressive surgery may be the only life-saving treatment. Patient and methods: We present the case of a puerperal young woman with progressive headache, seizures and decreased alertness. Thrombosis of the entire superior sagittal sinus with bifrontal venous infarcts and midline shift was confirmed by magnetic resonance imaging with venography sequencing. Despite medical treatment with anticoagulation, progressive neurological deterioration was observed, so bilateral, frontal decompressive craniectomy was performed. Results: At the 6-month follow-up, we observed partial functional recovery with a modified Rankin score of 3. Discussion: Bilateral decompressive craniectomy may be a life-saving therapeutic option when medical therapy fails and there are clinical and radiological features of progression in both cerebral hemispheres.https://www.ejcrim.com/index.php/EJCRIM/article/view/1560bilateral craniectomydecompressive craniectomymalignant cerebral venous thrombosis |
| spellingShingle | Eduardo Soriano-Navarro Vanessa Cano-Nigenda Fernanda Menéndez-Manjarrez Esmirna Farington-Terrero Juan José Méndez-Gallardo Alejandro García-Irigoyen Antonio Arauz Bilateral Decompressive Craniectomy in Malignant Cerebral Venous Thrombosis European Journal of Case Reports in Internal Medicine bilateral craniectomy decompressive craniectomy malignant cerebral venous thrombosis |
| title | Bilateral Decompressive Craniectomy in Malignant Cerebral Venous Thrombosis |
| title_full | Bilateral Decompressive Craniectomy in Malignant Cerebral Venous Thrombosis |
| title_fullStr | Bilateral Decompressive Craniectomy in Malignant Cerebral Venous Thrombosis |
| title_full_unstemmed | Bilateral Decompressive Craniectomy in Malignant Cerebral Venous Thrombosis |
| title_short | Bilateral Decompressive Craniectomy in Malignant Cerebral Venous Thrombosis |
| title_sort | bilateral decompressive craniectomy in malignant cerebral venous thrombosis |
| topic | bilateral craniectomy decompressive craniectomy malignant cerebral venous thrombosis |
| url | https://www.ejcrim.com/index.php/EJCRIM/article/view/1560 |
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