Christina Geisbüsch1, Daniel Richter1, Christian Herweh1, Peter A Ringleb1, Simon Nagel2. 1. From the Departments of Neurology (C.G., D.R., P.A.R., S.N.) and Neuroradiology (C.H.), University of Heidelberg, Heidelberg, Germany. 2. From the Departments of Neurology (C.G., D.R., P.A.R., S.N.) and Neuroradiology (C.H.), University of Heidelberg, Heidelberg, Germany. simon.nagel@med.uni-heidelberg.de.
Abstract
BACKGROUND AND PURPOSE: Thrombosis of cerebral veins and sinus (cerebral venous thrombosis) is a rare stroke pathogenesis. Pharmaceutical treatment is restricted to heparin and oral anticoagulation with vitamin K antagonists (VKAs). METHODS: Between January 2012 and December 2013, we recorded data from our patients with cerebral venous thrombosis. The modified Rankin scale was used to assess clinical severity; excellent outcome was defined as modified Rankin scale 0 to 1. Recanalization was assessed on follow-up MR angiography. Patients were then divided into 2 treatment groups: phenprocoumon (VKA) and a novel factor Xa inhibitor. Clinical and radiological baseline data, outcome, recanalization status, and complications were retrospectively compared. RESULTS: Sixteen patients were included, and 7 were treated with rivaroxaban. Overall outcome was excellent in 93.8%, and all patients showed at least partial recanalization. No statistical significant differences were found between the groups, except the use of heparin before start of oral anticoagulation (P=0.03). One patient in the VKA and 2 patients in the factor Xa inhibitor group had minor bleeding (P=0.55) within the median (range) follow-up of 8 months (5-26). CONCLUSIONS: Factor Xa inhibitor showed a similar clinical benefit as VKA in the treatment of cerebral venous thrombosis. Further systematic prospective evaluation is warranted.
BACKGROUND AND PURPOSE:Thrombosis of cerebral veins and sinus (cerebral venous thrombosis) is a rare stroke pathogenesis. Pharmaceutical treatment is restricted to heparin and oral anticoagulation with vitamin K antagonists (VKAs). METHODS: Between January 2012 and December 2013, we recorded data from our patients with cerebral venous thrombosis. The modified Rankin scale was used to assess clinical severity; excellent outcome was defined as modified Rankin scale 0 to 1. Recanalization was assessed on follow-up MR angiography. Patients were then divided into 2 treatment groups: phenprocoumon (VKA) and a novel factor Xa inhibitor. Clinical and radiological baseline data, outcome, recanalization status, and complications were retrospectively compared. RESULTS: Sixteen patients were included, and 7 were treated with rivaroxaban. Overall outcome was excellent in 93.8%, and all patients showed at least partial recanalization. No statistical significant differences were found between the groups, except the use of heparin before start of oral anticoagulation (P=0.03). One patient in the VKA and 2 patients in the factor Xa inhibitor group had minor bleeding (P=0.55) within the median (range) follow-up of 8 months (5-26). CONCLUSIONS:Factor Xa inhibitor showed a similar clinical benefit as VKA in the treatment of cerebral venous thrombosis. Further systematic prospective evaluation is warranted.
Authors: Satu Mustanoja; Tiina M Metso; Jukka Putaala; Noora Heikkinen; Elena Haapaniemi; Oili Salonen; Turgut Tatlisumak Journal: Brain Behav Date: 2015-05-30 Impact factor: 2.708
Authors: Diego Chemello; Larissa Rosa; Amanda Faria de Araujo; Pedro Cargnelutti de Araujo; Luiz Carlos Carneiro Pereira; Suélen Feijó Hillesheim; Marco Aurélio Lumertz Saffi Journal: J Vasc Bras Date: 2021-04-28