E-052 mechanical thrombectomy of the superior sagittal sinus using the penumbra device for cerebral venous thrombosis: a case report
Bibliographic record
Abstract
Background Cerebral venous thrombosis is a potentially devastating condition. Predisposing factors include hypercoagulable state, infection, pregnancy, oral contraceptive use and female sex. Symptoms may include headache, nausea, vomiting, and visual changes. Papilledema, focal neurologic deficits, strokes, and seizures may occur. Treatment consists of systemic anticoagulation and management of the underlying process. Acetazolamide and cerebrospinal fluid diversion are reserved for cases with refractory, severe intracranial hypertension. Recently, neurointerventional techniques have shown promise in the treatment of this condition. Case report We report the case of a 47-year-old male who presented with seizures and intracerebral hemorrhage. CT angiography showed near-complete occlusion of the superior sagittal sinus and occlusion of both transverse sinuses. Anticoagulation was initiated, but he continued to have seizures and his level of consciousness deteriorated. He was therefore taken to angiography and mechanical thrombectomy of his sagittal sinus was performed with the Penumbra device (Penumbra Inc., Alameda, California, USA). Flow was markedly improved in the superior sagittal sinus, and he recovered well post-operatively. He was discharged home on antiepileptic medication with no neurologic deficits. Conclusion Mechanical thrombectomy is a viable option for revascularization of the dural venous sinuses in the setting of cerebral venous thrombosis. Competing interests L Hnenny: None. D Fiorella: Codman and Shurtleff, Covidien ev3, NFocus Medical, Cordis, Micrus Endovascular. M Kelly: None.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.006 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".