José M Ferro1,2, Diana Aguiar de Sousa3,4. 1. Serviço de Neurologia, Department of Neurosciences and Mental Health, Centro Hospitalar Lisboa Norte, Instituto de Medicina Molecular, Lisbon, Portugal. jmferro@medicina.ulisboa.pt. 2. Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz s/n, 1649-035, Lisbon, Portugal. jmferro@medicina.ulisboa.pt. 3. Serviço de Neurologia, Department of Neurosciences and Mental Health, Centro Hospitalar Lisboa Norte, Instituto de Medicina Molecular, Lisbon, Portugal. 4. Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz s/n, 1649-035, Lisbon, Portugal.
Abstract
PURPOSE OF REVIEW: The purpose of this update is to summarize the recent advances on the management of cerebral venous thrombosis (CVT). RECENT FINDINGS: There is a trend in declining frequency of CVT patients presenting with focal deficits or coma and a decrease in mortality over time. Anemia and obesity were identified as risk factors for CVT. During pregnancy and puerperium, the higher risk of CVT occurs in the first months post-delivery. With appropriate management, 1/3 of comatose CVT patients can have a full recovery. The management of CVT patients includes treatment of associated conditions, anticoagulation with parenteral heparin, prevention of recurrent seizures, and decompressive neurosurgery in patients with large venous infarcts/hemorrhages with impending herniation. After the acute phase, patients should be anticoagulated for 3-12 months. Results of recently completed randomized controlled trials on endovascular treatment and comparing dabigatran with warfarin will improve the treatment of CVT.
PURPOSE OF REVIEW: The purpose of this update is to summarize the recent advances on the management of cerebral venous thrombosis (CVT). RECENT FINDINGS: There is a trend in declining frequency of CVTpatients presenting with focal deficits or coma and a decrease in mortality over time. Anemia and obesity were identified as risk factors for CVT. During pregnancy and puerperium, the higher risk of CVT occurs in the first months post-delivery. With appropriate management, 1/3 of comatose CVTpatients can have a full recovery. The management of CVTpatients includes treatment of associated conditions, anticoagulation with parenteral heparin, prevention of recurrent seizures, and decompressive neurosurgery in patients with large venous infarcts/hemorrhages with impending herniation. After the acute phase, patients should be anticoagulated for 3-12 months. Results of recently completed randomized controlled trials on endovascular treatment and comparing dabigatran with warfarin will improve the treatment of CVT.
Authors: José M Ferro; Patrícia Canhão; Marie-Germaine Bousser; Jan Stam; Fernando Barinagarrementeria Journal: Stroke Date: 2005-08-11 Impact factor: 7.914
Authors: José M Ferro; Patrícia Canhão; Jan Stam; Marie-Germaine Bousser; Fernando Barinagarrementeria Journal: Stroke Date: 2004-02-19 Impact factor: 7.914
Authors: José M Ferro; Patrícia Canhão; Marie-Germaine Bousser; Jan Stam; Fernando Barinagarrementeria Journal: Stroke Date: 2008-02-28 Impact factor: 7.914
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