Incidence ofcerebral venous sinus thrombosis(CVST) is more common in Indian subcontinent accounting for 10% to 20% of all young strokes. The mortality in these patients is highly variable between 5% and 30%. Identifying the patients with severe clinical grade at an early stage and endovascular lysis in this subgroup yields good results and favorable outcome.The aim of the present series is to analyze the safety and efficacy of insitu thrombolysis in patients with cerebral venous sinus thrombosis in severe clinical grade and refractory to conventional...

46 patients(22 males and 24 females )with age ranging from 19 years to 62 years, presented to us with cerebral venous thrombosis in severe clinical grade refractory to Medical management subsequently receivedin situthrombolysis during a 5-year period (April 2013 to April 2018) were included in the study.The grading of CVT was done using the criteria proposed by INR, King Edward Memorial Hospital (KEM), Mumbai, India(table 1).Tissue plasminogen activator (tpa) was used in all the patients.All procedures were performed on Axiom Artis Zee, Siemens, Germany. Digital...

Indications for thrombolysis included clinical deterioration despite adequate anticoagulation and rapid worsening of consciousness or neurological deficits. Venous infarcts were present in 41 patients. Technical success in form of recanalization of the affected sinuses was achieved in all the cases. Mechanical laceration favored use of lower dose of tpa as compared to other studies and recanalization is faster when compared to urokinase.39 patients had good outcome (mRs 0 or1) and 5 patients had mild deficits (mRs 2). One patient had moderate disability (mRs 3). One...

Rapid and sustained recovery is seen in majority of our patients with LIST. Our study highlights the benefit of thrombolysis and mechanical clot laceration, particularly in severe grade patients, and in patients unresponsive to anticoagulation. There are no randomized controlled series in the literature comparing the efficacy of endovascular therapy versus systemic anticoagulation.Intrasinus thrombolysis is safe and effective in patients with CVST who fail to respond to conventional medical treatment. The improved efficacy of this therapy depends on early recognition of worsening symptoms and timely...

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