Journal
CURRENT NEUROLOGY AND NEUROSCIENCE REPORTS
Volume 19, Issue 10, Pages -Publisher
SPRINGER
DOI: 10.1007/s11910-019-0988-x
Keywords
Cerebral venous thrombosis; Dural sinus thrombosis; Cerebral vein; CT venography; MR venography; MRI; Prognosis; Anticoagulants; Dabigatran; Seizures; Intracranial hypertension; Decompressive surgery; Hemicraniectomy; Thrombolysis; Thrombectomy; Pregnancy
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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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