Clinical analysis with combined thrombolysis versus systemic anticoagulation for cerebral venous and sinus thrombosis / 中华神经科杂志

ABSTRACT

ObjectiveTo compare the safety and efficacy of combined thrombolysis and systemic anticoagulation therapy for the treatment of cerebral venous and sinus thrombosis (CVST).MethodsA retrospective review of consecutive inpatients with CVST was undertaken. Patients were divided into two groups,combined thrombolysis group (CTG) and systemic anticoagulation group (SAG).CTG underwent improved thrombolysis scheme which included mechanical thrombus maceration and unremitting microdosis urokinase injection into the venous sinus besides low molecular weight heparin anticoagulation.Neurological deficits before and after treatment were graded with the National Institute of Health Stroke Scale (NIHSS).Functional outcomes at discharge were graded on the modified Rankin Scale (mRS).ResultsThere were 30 cases in CTG ( male =9) and 86 cases in SAG ( male =23 ).There was no significant difference of neurological deficits before treatment between two groups(0-19 vs 0-17,Z =-0.474,P =0.636).After treatment,NIHSS and mRS at discharge were significantly decreased in CTG compared to SAG.There was no significant difference on the incidence of intracerebral hemorrhage.Conclusions Combined thrombolysis is better than systemic anticoagulation in improving neurological function.Combined thrombolysis does not increase incidence of ICH compared to systemic anticoagulation.