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Cerebral Venous Thrombosis: an Update
José M Ferro1,2, Diana Aguiar de Sousa3,4
1Serviço de Neurologia, Department of Neurosciences and Mental Health, Centro Hospitalar Lisboa Norte, Instituto de Medicina Molecular, Lisbon, Portugal. jmferro@medicina.ulisboa.pt.
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.
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