J Neurol Surg B Skull Base 2021; 82(S 03): e3-e8
DOI: 10.1055/s-0039-3400296
Original Article

Dural Venous Sinus Thrombosis after Vestibular Schwannoma Surgery: The Anticoagulation Dilemma

Bledi C. Brahimaj
1   Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, United States
,
Andre Beer-Furlan
1   Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, United States
,
Fred Crawford
2   Rush University College of Medicine, Chicago, Illinois, United States
,
Ravi Nunna
1   Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, United States
,
Matthew Urban
2   Rush University College of Medicine, Chicago, Illinois, United States
,
Gary Wu
2   Rush University College of Medicine, Chicago, Illinois, United States
,
Eric Abello
2   Rush University College of Medicine, Chicago, Illinois, United States
,
Vikrant Chauhan
3   Department of Otolaryngology, Rush University Medical Center, Chicago, Illinois, United States
,
Mehmet Kocak
4   Department of Diagnostic Radiology, Rush University Medical Center, Chicago, Illinois, United States
,
Lorenzo Muñoz
1   Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, United States
,
Richard M. Wiet
3   Department of Otolaryngology, Rush University Medical Center, Chicago, Illinois, United States
,
Richard W. Byrne
1   Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, United States
› Institutsangaben
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Abstract

Introduction Dural venous sinus thrombosis (DVST) is a relatively understudied complication of vestibular schwannoma (VS) surgery. Several studies have examined this topic; however, there is limited data on the incidence, clinical progression, and proper management of this patient population.

Methods A retrospective review was performed for patients undergoing surgery for VS at a single institution. All postoperative imaging was reviewed for incidence of DVST. Demographic data were collected including tumor and surgical characteristics along with postoperative course.

Results A total of 63 patients underwent resection of their VS. The incidence of DVST was 34.9%. The operative time was greater in the dural venous sinus thrombosis (DSVT) group, at an average of 6.69 hours versus 4.87 in the no DSVT cohort (p = 0.04). Tumor size was correlationally significant (p = 0.051) at 2.75 versus 2.12 cm greatest diameter. The translabyrinthine approach was most prevalent (68.2%). The side of the thrombosis was ipsilateral to the tumor and surgery in all patients. The sigmoid sinus was most commonly involved (95.5%). Of them, 85% patients had a codominant or thrombus contralateral to the dominant sinus. All patients were asymptomatic. No patients were treated with anticoagulation. Resolution of thrombus was seen in five (22.7%) of the patients on last follow-up imaging. There were no hemorrhagic complications.

Conclusion The overall incidence of DVST was (34.9%) of 63 patients who underwent VS surgery. All patients were asymptomatic and none were treated with anticoagulation. In our study, continuing to observe asymptomatic patients did not lead to any adverse events.



Publikationsverlauf

Eingereicht: 31. Mai 2019

Angenommen: 27. September 2019

Artikel online veröffentlicht:
21. November 2019

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