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Cerebral Venous Thrombosis: an Update

  • Stroke (H.C. Diener, Section Editor)
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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.

Summary

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.

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Authors and Affiliations

  1. Serviço de Neurologia, Department of Neurosciences and Mental Health, Centro Hospitalar Lisboa Norte, Instituto de Medicina Molecular, Lisbon, Portugal

    José M. Ferro & Diana Aguiar de Sousa

  2. Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz s/n, 1649-035, Lisbon, Portugal

    José M. Ferro & Diana Aguiar de Sousa

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José M. Ferro reports personal fees from Boehringer Ingelheim (principal investigator RE-SPECT CVT trial) during the conduct of the study. Dr. Ferro also reports grants from Boehringer Ingelheim, outside the submitted work, and grants and personal fees from Bayer, outside the submitted work. Diana Aguiar de Sousa declares no potential conflicts of interest.

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Ferro, J.M., Aguiar de Sousa, D. Cerebral Venous Thrombosis: an Update. Curr Neurol Neurosci Rep 19, 74 (2019). https://doi.org/10.1007/s11910-019-0988-x

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