Refractory deep cerebral venous thrombosis managed by mechanical thrombectomy and balloon angioplasty: A case report

Deep cerebral venous thrombosis (DCVT) is a rare but potentially life-threatening subtype of cerebral venous sinus thrombosis that can lead to rapid neurological deterioration. Anticoagulation remains the first-line therapy; however, some cases exhibit poor clinical response and may require endovascular intervention. We report a case of a 16-year-old female presenting with impaired consciousness (Glasgow Coma Scale score of 9). Brain MRI revealed venous infarction and thrombosis involving the vein of Galen and the straight sinus. Despite prompt anticoagulation with low-molecular-weight heparin, her neurological status showed limited improvement. Endovascular therapy was indicated, and balloon angioplasty of the straight sinus followed by mechanical thrombectomy using a large-bore aspiration catheter was successfully performed. Postprocedural venous recanalization was achieved without complications, resulting in significant neurological recovery (discharge GCS 15). This case highlights the crucial role of interventional radiology in managing refractory cerebral venous thrombosis, demonstrating that timely mechanical thrombectomy and balloon angioplasty can be both safe and effective in restoring venous outflow and improving clinical outcomes.