To evaluate the safety and efficacy of endovascular treatment for patients with acute severe cerebral venous sinus thrombosis.

Clinical data were collected from 3 patients diagnosed with acute severe cerebral venous sinus thrombosis who underwent with endovascular treatment at the First Affiliated Hospital, Air Force Medical University from February 1 to June 1, 2024. A retrospective analysis was conducted on their clinical manifestations, imaging characteristics, surgical techniques and devices used, medication regimens, and follow-up outcomes, supplemented by a review of relevant literature.

The cohort consisted of two female patients (one in early pregnancy and one postpartum) and one male patient. All three exhibited clinical manifestations of intracranial hypertension and hemiplegia, with one case showing conscious disturbance and two experiencing epileptic seizures. Cranial imaging revealed venous cerebral infarction in all patients, involving the superior sagittal sinus and bilateral transverse sinuses, with two cases showing hemorrhagic transformation. All patients underwent thrombectomy using Solitaire (6 mm×30 mm) stents-retriever combined with intermediate catheter retrieval technique, achieving partial recanalization. Subsequent catheter-directed intravenous thrombolysis resulted in satisfactory recanalization outcomes and rapid clinical improvement.

Endovascular treatment demonstrates both safety and efficacy in the management of acute severe cerebral venous sinus thrombosis.