Neurointerventional nursing management during mechanical thrombectomy: A case report of cerebral venous sinus thrombosis

Introduction: Cerebral venous sinus thrombosis (CVST) is an important neurovascular disease that develops as a result of thrombus formation in the cerebral venous system. It can present with a variety of clinical findings, such as headache, seizures, focal neurological deficits, and altered consciousness. Anticoagulation is the cornerstone of treatment, but endovascular treatment may be considered in selected patients who deteriorate clinically despite appropriate medical therapy. This case report aims to present neurointerventional nursing management in a patient who underwent venous mechanical thrombectomy. The study was prepared as a case report of a patient who underwent venous mechanical thrombectomy with a diagnosis of CVST. Nursing management was evaluated in three phases: before, during, and after the procedure. Before the procedure, neurological status and vital signs were assessed, and intravenous access, laboratory results, and required materials were checked. During the procedure, neurological and hemodynamic monitoring was performed, and sterility and team coordination were maintained. After the procedure, neurological status, vital signs, the access site, bleeding, hematoma, and distal circulation were assessed.Case: The patient was evaluated for right-sided headache, blurred vision, nausea, word-finding difficulty, and right facial paresis that had persisted for 5 days. During follow-up, the patient became drowsy with a fluctuating level of consciousness and mixed aphasia; right upper extremity strength was 1/5 and lower extremity strength 3/5, and epileptic seizures occurred. Imaging revealed right transverse sinus thrombosis and signs of hemorrhagic infarction in the right parieto-occipital region. Because of clinical deterioration, venous mechanical thrombectomy was performed. Two nurses carried out simultaneous bilateral manual thromboaspiration, and approximately 6–7 mechanical thrombectomy passes were made. Partial recanalization was achieved at the end of the procedure. No increase in bleeding was observed afterward; the headache subsided, and speech and motor findings improved.Discussion/Conclusion: In selected patients with CVST who deteriorate clinically, endovascular treatment can be applied. The neurointerventional nurse plays an active role in preparation before the procedure, neurological and hemodynamic monitoring during the procedure, team coordination, and early recognition of postprocedural complications. In this case, partial recanalization was achieved after mechanical thrombectomy, and the patient’s clinical condition improved markedly.Keywords: