Do we have to anticoagulate patients with cerebral venous thrombosis?

Cerebral venous thrombosis (CVT) is a rare form of venous thromboembolism (VTE). Although anticoagulation is recommended for the initial and long term treatment with regards to thrombotic risks for patients with CVT, the role of anticogalution has not been fully elucidated. The aim of our literature based review was collect articles showing the benefit of anticoagulation in CVT and gathering the data of follow-up studies focusing on the recurrence of CVT and other thrombotic events. We have identified 15 follow-up studies studies with 2422 patients. The mean duration of follow-up was 37.9 months. Death occured in 6.5% and 76.4% of the patients had favorable outcome; 85.5% received initial anticoagulation with ultrafractionated or low molecular weight heparin and 82.1% received long-term anticoagulation. Recurent CVT occured in 3.7% and other thrombotic event occured in 5.4%. The mentioned studies have led to incoclusive results with regards to the clinical outcome and the presence or absence of anticoagulation. The role of long term anticoagulation should be clarified in randomized multicentre studies as the recurrence rate seems to be low and the outcome of a second event as good as that of the first one irrespective of underlying risk factors.