EFNS guideline on the treatment of cerebral venous and sinus thrombosis

@article{Einhaupl2006EFNSGO,
  title={EFNS guideline on the treatment of cerebral venous and sinus thrombosis},
  author={Karl Max Einhäupl and Marie Germaine Bousser and S.F.T.M. de Bruijn and Jos{\'e} M. Ferro and Ida Martinelli and Florian Masuhr and Jan Jacob Stam},
  journal={European Journal of Neurology},
  year={2006},
  volume={13}
}
Cerebral venous and sinus thrombosis (CVST) is a rather rare disease which accounts for <1% of all strokes. Diagnosis is still frequently overlooked or delayed due to the wide spectrum of clinical symptoms and the often subacute or lingering onset. Current therapeutic measures which are used in clinical practice include the use of anticoagulants such as dose‐adjusted intravenous heparin or body weight‐adjusted subcutaneous low‐molecular‐weight heparin (LMWH), the use of thrombolysis, and… 

Treatment of cerebral venous and sinus thrombosis.

TLDR
The strength of evidence reported in the literature to support the use of anticoagulants, thrombolysis, and symptomatic therapy including control of seizures and elevated intracranial pressure is reviewed and treatment recommendations based on the best available evidence are provided.

A review of therapeutic strategies for the management of cerebral venous sinus thrombosis.

TLDR
Effective treatments exist for the management of CVST, and overall outcomes are more favorable than those for arterial stroke.

Cerebral Venous Thrombosis: Current and Newer Anticoagulant Treatment Options

TLDR
CVT is a rare neurological disease with potentially serious implications and high neurological morbidity and mortality rates, and although heparin and warfarin have been used for more than 50 years, newer oral anticoagulants might offer an alternative to traditional therapy.

Anticoagulation in cerebral venous sinus thrombosis

  • C. Davie
  • Medicine
    European journal of neurology
  • 2012
TLDR
A randomized controlled trial of LMWH versus unfractionated heparin (UFH) in CVST shows better outcomes in patients presenting with isolated intracranial hypertension and substantially worse outcomes in Patients with underlying malignancy or infection, a Glasgow Coma Score < 9, or the presence of deep venous system thrombosis.

Evaluation and managment of CVT ( Continuum )

TLDR
Cerebral venous thrombosis is an important diagnosis to keep in mind when evaluating patients with headache in the emergency department, and it is important that it not be overlooked because it is treatable.

Evaluation and Management of Cerebral Venous Thrombosis

TLDR
CVT is an important diagnosis to keep in mind when evaluating patients with headache in the emergency department, and it is important that it not be overlooked because it is treatable.

Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment.

TLDR
The recent advances in the diagnosis and treatment of patients with CVST have significantly lowered the associated mortality and morbidity and have improved the outcome of these patients.

How to treat cerebral venous and sinus thrombosis

TLDR
In this review, the available treatment options for CVT are summarized and which therapy should be reserved for which patients are suggested.

Evaluation and managment of CVT (Continuum).pdf

TLDR
Cerebral venous thrombosis is an important diagnosis to keep in mind when evaluating patients with headache in the emergency department, and it is important that it not be overlooked because it is treatable.
...

References

SHOWING 1-10 OF 42 REFERENCES

Thrombolytics for cerebral sinus thrombosis: a systematic review.

TLDR
Thrombolytics appeared to be reasonably safe in CVDST, but its efficacy cannot be assessed from the published data.

Anticoagulation for Cerebral Sinus Thrombosis

TLDR
Based upon the limited evidence available, anticoagulant treatment for cerebral sinus thrombosis appeared to be safe and was associated with a potentially important reduction in the risk of death or dependency which did not reach statistical significance.

Heparin Treatment in Cerebral Sinus and Venous Thrombosis: Patients at Risk of Fatal Outcome

TLDR
There was a strong link between the outcome and the level of vigilance; there was reason to assume that ICH represented an epiphenomenon of a severe course rather than an independent predictor, and other investigated parameters were not linked with a fatal outcome.

Cerebral venous thrombosis: nothing, heparin, or local thrombolysis?

TLDR
The present “gold standard” for the diagnosis of CVT is no longer angiography but MRI, which visualizes the thrombosed sinus as an increased signal on both T1- and T2-weighted imaging.

Treatment of dural sinus thrombosis using selective catheterization and urokinase

TLDR
Treatment of 12 more patients with cerebral venous sinus thrombosis with transfemoral, venous intradural infusions of the fibrinolytic agent urokinase with good to excellent clinical outcome was achieved.

Heparin treatment in sinus venous thrombosis

[Cerebral venous thrombosis].

TLDR
Hemostatic disorders are the leading causes of cerebral venous thrombosis, in particular, constitutional thromBophilia often associated with one or several promoting factors such as use of oral contraception, which explains the incidence peak among young women.

Seizures in Cerebral Vein and Dural Sinus Thrombosis

TLDR
Patients with early symptomatic seizures and cerebral lesions on admission CT/MR after CVDST should probably be limited to patients with motor and sensory deficits and in those with focal oedema/ischaemic infarcts or haemorrhages on admissionCT/MR.

Prognosis of Cerebral Vein and Dural Sinus Thrombosis: Results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT)

TLDR
A subgroup of clinically identifiable CVT patients is at increased risk of bad outcome and may benefit from more aggressive therapeutic interventions, to be studied in randomized clinical trials.

Cerebral venous thrombosis--a review of 38 cases.

TLDR
This study shows that CVT is not rare, that the clinical diagnosis is extremely difficult because of the variable modes of onset and groupings of symptoms, that most CT findings are non specific and that angiography remains the best diagnostic tool.