{"id":"88598449-7ed8-4d42-9d49-f6397f320718","slug":"dural-sinus-mechanical-thrombectomy-and-continuous-local-rt-pa-infusion-in-a-child-with-refractory-intracranial-hypertension-and-progressive-visual-loss-a-case-report","title":"Dural sinus mechanical thrombectomy and continuous local rt-PA infusion in a child with refractory intracranial hypertension and progressive visual loss: A case report","authors":["Martino Cellerini","Rosa Francavilla","Caterina Testoni","Monica Maffei","Mino Zucchelli","Chiara Ghizzi"],"abstract":"Background: Children with intracranial hypertension are at risk for visual loss and their visual function must be closely monitored. Surgery with the insertion of a ventriculoperitoneal shunt is imperative when vision is threatened. Case Description: Herein, we report a case of a 5-year-old boy whose refractory intracranial hypertension and severe, progressive visual loss (secondary to a chronic, otogenic, right sigmoid sinus thrombosis, and a contralateral sinus tight stenosis) were resolved by a combination of continuous (6 h), locoregional, infusion of recombinant tissue plasminogen activator (rt-PA), and mechanical thrombectomy. Conclusion: The association of in loco and continuous infusion of recombinant tissue plasminogen activator (rt- PA) with mechanical thrombectomy resulted in effective in partially reopening the occluded sinus and facilitating a good clinical recovery. This combined endovascular approach may represent an alternative, less invasive, therapeutic option to surgery in children with intracranial hypertension caused by chronic cerebral venous sinus thrombosis.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/88598449-7ed8-4d42-9d49-f6397f320718/featured/hero-1781563207987.png","publishDate":"2020-08-21T00:00:00.000Z","doi":"10.25259/SNI_236_2020","categories":["Neurovascular","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2020/08/10222/SNI-11-253.pdf"}