Update on management of cerebral venous thrombosis.


Journal

Current opinion in neurology
ISSN: 1473-6551
Titre abrégé: Curr Opin Neurol
Pays: England
ID NLM: 9319162

Informations de publication

Date de publication:
22 Oct 2024
Historique:
medline: 29 10 2024
pubmed: 29 10 2024
entrez: 29 10 2024
Statut: aheadofprint

Résumé

This review intends to systematize the diagnostic and treatment approach to cerebral venous thrombosis (CVT), highlighting key studies that have been recently published. In light of the recent pandemic, new risk factors for CVT have emerged. Contrast-enhanced MRI and susceptibility-weighted imaging have been shown to offer increased sensitivity for detecting cortical vein thrombosis.Dabigatran seems to be as effective and well tolerated as warfarin for long-term anticoagulation. Partial venous recanalization often occurs in patients treated with anticoagulation only, as early as 8 days after treatment onset. For patients with CVT and impending brain herniation, two-thirds of those who undergo decompressive craniectomy survive, with one-third being functionally independent 6 months after diagnosis. CVT is an unusual type of cerebrovascular disease that mostly affects women of fertile age. Risk factors should be identified and addressed. Diagnosis relies on confirmation of venous sinus and/or vein thrombosis, usually by CT venography or MRI. Anticoagulation is the cornerstone of treatment. Despite the lack of high-quality evidence, endovascular treatment is often considered in severe cases. Special populations require tailored approaches. About 80% achieve mRS 0-1, but residual symptoms often affect quality of life and the ability to return to work.

Identifiants

pubmed: 39469812
doi: 10.1097/WCO.0000000000001329
pii: 00019052-990000000-00204
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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Auteurs

Sara Rosa (S)

Neuroradiology Department, Lisbon Central University Hospital - ULS São José.
Faculdade de Medicina, Universidade de Lisboa.

Isabel Fragata (I)

Neuroradiology Department, Lisbon Central University Hospital - ULS São José.
NOVA Medical School, NOVA University of Lisbon.

Diana Aguiar de Sousa (D)

Faculdade de Medicina, Universidade de Lisboa.
Stroke Center, Lisbon Central University Hospital - ULS São José and Gulbenkian Institute of Molecular Medicine, Lisbon, Portugal.

Classifications MeSH