OBJECTIVE There are no guidelines for the management of postoperative lateral sinus thrombosis following posterior fossa surgery. Introducing treatment-dose anticoagulant therapy during the immediate postoperative period increases the risk of intracranial bleeding. This study assessed the incidence of and risk factors associated with postoperative lateral sinus thrombosis and the complications related to thrombosis and/or anticoagulation. METHODS This study was a retrospective monocentric analysis of adult patients who underwent surgical removal of a posterior fossa space-occupying lesion with available postoperative imaging. Postoperative lateral sinus thrombosis was defined as a T2 hypointensity within the venous sinus and/or a filling defect on postcontrast MRI or CT scan. RESULTS Among 180 patients, 12 (6.7%; 95% CI 3.0-10.4) were found to have lateral sinus thrombosis on postoperative imaging, none of whom were symptomatic. Unadjusted risk factors for postoperative lateral sinus thrombosis were a history of deep venous thrombosis (p = 0.016), oral contraceptive pill (p = 0.004), midline surgical approach (p = 0.035), and surgical exposure of the sinus (p < 0.001). Seven of the patients (58.3%) with a postoperative lateral sinus thrombosis received immediate treatment-dose anticoagulant therapy. Lateral sinus recanalization occurred radiologically at a mean time of 272 ± 23 days in 85.7% of patients (6 of 7) undergoing treatment-dose anticoagulant therapy and in 20% of patients (1 of 5) not receiving treatment-dose anticoagulant therapy. Postoperative complications occurred in 56.2% of patients (9 of 16) who received treatment-dose curative anticoagulant therapy and in 27% of patients (45 of 164) who did not. CONCLUSIONS Incidental radiological lateral sinus thrombosis following posterior fossa surgery has an incidence of 6.7%. To further define the benefit-to-risk ratio of a treatment-dose anticoagulant therapy, a prospective trial should be considered.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.3171/2015.11.JNS151881 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Anesthesia Management for Epicardial Pacemaker Electrode Implantation in a Patient With a History of Fontan Procedure: A Case Report.
Cureus
December 2024
Department of Anaesthesiology, Seirei Hamamatsu General Hospital, Hamamatsu, JPN.
One-lung ventilation is commonly used in lateral open chest surgery; however, it can increase pulmonary vascular resistance, which negatively affects Fontan circulation. Nevertheless, one-lung ventilation has a positive indication in post-Fontan patients. It allows surgery with lateral minimally invasive thoracotomy, which does not require a median sternotomy.
View Article and Find Full Text PDFNon-Thrombotic Filling Defects in Cerebral Veins and Sinuses: When Normal Structures Mimic a Disease.
Neurol Int
January 2025
Neuroradiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123 Reggio Emilia, Italy.
Cerebral venous thrombosis (CVT) is a rare and potentially critical cerebrovascular disease involving intracranial dural sinuses and veins. The diagnosis is a stepwise pathway starting from clinical suspicion and employing several neuroradiological techniques, mainly Computed Tomography (CT)-based and Magnetic Resonance Imaging (MRI)-based modalities. The neuroradiological findings, both in the diagnostic phase and in the follow-up phase, may provide some results at risk for misdiagnosis.
View Article and Find Full Text PDF: Vertical atrophy of the maxilla has traditionally been treated with sinus lift procedures and implant placement, performed in one or two surgical stages. Subsequently, the transcrestal sinus lift technique was introduced, offering distinct advantages in terms of indications and reduced morbidity. Most recently, short implants have emerged as a valid alternative to these procedures, even in cases of severe horizontal resorption, allowing for direct placement in many cases.
View Article and Find Full Text PDFShunt Dependency Syndrome Combined with Sinus Stenosis after Cyst-peritoneal Shunting of Arachnoid Cyst: A 20-year Rare Complication.
NMC Case Rep J
December 2024
Department of Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Shunt dependence syndrome is a serious long-term complication characterized by symptoms and signs of increased intracranial pressure with normal-sized lateral ventricles after several years of arachnoid cyst-peritoneal shunting. It is easy to misdiagnose and overlook when combined with sinus stenosis, thus delaying treatment. Here, we present a 35-year-old man with an unexplained headache and binocular horizontal diplopia with high intracranial pressure.
View Article and Find Full Text PDFDominant Occipital Sinus: A Rare Anatomical Variant With Potentially Catastrophic Consequences if Unrecognized Preoperatively.
Cureus
December 2024
Department of Neurosurgery, Southmead Hospital, North Bristol NHS Trust, Bristol, GBR.
The occipital sinus is often thought of as a redundant vestigial structure in adults. However, in rare cases, it can form the dominant route of intracerebral venous drainage, with a risk of significant surgical morbidity if unrecognised. We present an illustrative case describing this anatomical variant and tailoring of a midline suboccipital craniotomy to allow resection of a fourth ventricular epidermoid tumour with preservation of a dominant occipital sinus, and a review of the published literature.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!