A patient with deep cerebral venous sinus thrombosis in whom neuroendovascular therapy was effective.

A 63-year-old man presented with aphasia. A computed tomographic scan of the head revealed hemorrhagic infarction in the left temporal lobe. Magnetic resonance venography (MRV) revealed no flow from the straight sinus and left transverse sinus to the sigmoid sinus, indicating cerebral venous sinus thrombosis (CVST). Because of rapidly deteriorating consciousness despite heparin infusion, neuroendovascular therapy was performed, recanalization was achieved, and the level of consciousness improved. In Western countries, neuroendovascular therapy is often aggressively performed in patients with worsening symptoms despite anticoagulation. However, in Japan, such reports are extremely rare. We recommend neuroendovascular therapy for deep CVST resistant to anticoagulant therapy.