Surgical Thrombectomy for Extensive Cerebral Venous Sinus Thrombosis after COVID-19 Vaccination : A Novel Surgical Technique and Literature Review.

IF 1.4 4区 医学 Q4 CLINICAL NEUROLOGY
Journal of Korean Neurosurgical Society Pub Date : 2024-09-01 Epub Date: 2023-03-02 DOI:10.3340/jkns.2023.0026
Yuwhan Chung, Jiwook Ryu, Seok Keun Choi
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引用次数: 0

Abstract

Surgical treatment of refractory and extensive cerebral venous sinus thrombosis (CVST) has limited applications. Here, we describe an open, direct sinus thrombectomy in the early phase of extensive CVST. A 49-year-old man with extensive CVST that occurred after the coronavirus disease 2019 (COVID-19) vaccination and affected the drainage of the Labbé vein presented with clinical deterioration and left temporal hemorrhagic infarction. Since the patient had extensive CVST, we determined that systemic anticoagulation and endovascular treatment were not suitable treatment options. Therefore, we decided on an emergency surgical treatment and performed direct surgical thrombectomy. We followed extended suboccipital approach and made multiple incisions on the sinuses, exposing the posterior superior sagittal sinus to the transverse sigmoid junction. Consequently, the clinical condition of the patient dramatically improved, resulting in a favorable outcome with a modified Rankin scale score of 0. Performing emergency open surgical thrombectomy was a technically feasible treatment option that recanalize obstructed sinuses. Importantly, the patient recovered with a good clinical outcome. Early maximal surgical thrombectomy can be an effective and lifesaving method to treat extensive CVST with hemorrhagic infarction.

COVID-19疫苗接种后广泛脑静脉窦血栓形成的外科血栓切除术:一种新的外科技术和文献综述。
手术治疗难治性和广泛性脑静脉窦血栓形成(CVST)的应用非常有限。在此,我们描述了在广泛 CVST 早期阶段的开放式直接窦血栓切除术。一名 49 岁的男性患者在接种冠状病毒病 2019(COVID-19)疫苗后发生了广泛的 CVST,并影响了拉贝静脉的引流,出现了临床恶化和左颞部出血性梗死。由于患者患有广泛的 CVST,我们认为全身抗凝和血管内治疗并不是合适的治疗方案。因此,我们决定采取紧急手术治疗,并直接进行了手术血栓切除术。我们采用枕下延伸入路,在鼻窦上做了多个切口,暴露了后上矢状窦到乙状结肠横交界处。急诊开放手术血栓切除术是一种技术上可行的治疗方案,可以重新疏通阻塞的静脉窦。重要的是,患者康复后临床疗效良好。早期最大限度的外科血栓切除术是治疗大面积 CVST 出血性梗死的有效救命方法。
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来源期刊
CiteScore
2.90
自引率
6.20%
发文量
109
审稿时长
3-8 weeks
期刊介绍: The Journal of Korean Neurosurgical Society (J Korean Neurosurg Soc) is the official journal of the Korean Neurosurgical Society, and published bimonthly (1st day of January, March, May, July, September, and November). It launched in October 31, 1972 with Volume 1 and Number 1. J Korean Neurosurg Soc aims to allow neurosurgeons from around the world to enrich their knowledge of patient management, education, and clinical or experimental research, and hence their professionalism. This journal publishes Laboratory Investigations, Clinical Articles, Review Articles, Case Reports, Technical Notes, and Letters to the Editor. Our field of interest involves clinical neurosurgery (cerebrovascular disease, neuro-oncology, skull base neurosurgery, spine, pediatric neurosurgery, functional neurosurgery, epilepsy, neuro-trauma, and peripheral nerve disease) and laboratory work in neuroscience.
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