Controversies of Treatment Modalities for Cerebral Venous Thrombosis
Cerebral vein thrombosis has been well recognized for nearly two centuries. However, therapeutic options for the condition are limited due to lack of large randomized trials. The various modalities reportedly used include antiplatelets, anticoagulation, fibrinolysis, and mechanical thrombectomy. Of...
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Wiley
2010-01-01
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| Series: | Stroke Research and Treatment |
| Online Access: | http://dx.doi.org/10.4061/2010/956302 |
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| author | Maria Khan Ayeesha Kamran Kamal Mohammad Wasay |
| author_facet | Maria Khan Ayeesha Kamran Kamal Mohammad Wasay |
| author_sort | Maria Khan |
| collection | DOAJ |
| description | Cerebral vein thrombosis has been well recognized for nearly two centuries. However, therapeutic options for the condition are limited due to lack of large randomized trials. The various modalities reportedly used include antiplatelets, anticoagulation, fibrinolysis, and mechanical thrombectomy. Of these, antiplatelets are the least studied, and there are only anecdotal reports of aspirin use. Anticoagulation is the most widely used and accepted modality with favorable outcomes documented in two randomized controlled trials. Various fibrinolytic agents have also been tried. Local infusions have shown more promise compared to systemic agents. Similarly, mechanical thrombectomy has been used to augment the effects of chemical thrombolysis. However, in the absence of randomized controlled trials; there is no concrete evidence of the safety and efficacy of either of these modalities. Limited study series disclosed that decompression surgery in malignant CVT can be life saving and provides good neurological outcome in some cases. Conclusion. Overall therapeutics for CVT need larger randomized controlled trials. Anticoagulaion with heparin is the only modality with a reasonable evidence to support its use in CVT. Endovascular thrombolysis and mechanical thrombectomy are reserved for selected cases who fail anticoagulation and decompression surgery for malignant CVT with impending herniation. |
| format | Article |
| id | doaj-art-41a37ed8883a4fd4a62c3b9f3e07f5d2 |
| institution | Kabale University |
| issn | 2042-0056 |
| language | English |
| publishDate | 2010-01-01 |
| publisher | Wiley |
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| series | Stroke Research and Treatment |
| spelling | doaj-art-41a37ed8883a4fd4a62c3b9f3e07f5d22025-08-20T03:55:40ZengWileyStroke Research and Treatment2042-00562010-01-01201010.4061/2010/956302956302Controversies of Treatment Modalities for Cerebral Venous ThrombosisMaria Khan0Ayeesha Kamran Kamal1Mohammad Wasay2Department of Medicine (Neurology), Aga Khan University, Stadium Road, Karachi 74800, PakistanDepartment of Medicine (Neurology), Aga Khan University, Stadium Road, Karachi 74800, PakistanDepartment of Medicine (Neurology), Aga Khan University, Stadium Road, Karachi 74800, PakistanCerebral vein thrombosis has been well recognized for nearly two centuries. However, therapeutic options for the condition are limited due to lack of large randomized trials. The various modalities reportedly used include antiplatelets, anticoagulation, fibrinolysis, and mechanical thrombectomy. Of these, antiplatelets are the least studied, and there are only anecdotal reports of aspirin use. Anticoagulation is the most widely used and accepted modality with favorable outcomes documented in two randomized controlled trials. Various fibrinolytic agents have also been tried. Local infusions have shown more promise compared to systemic agents. Similarly, mechanical thrombectomy has been used to augment the effects of chemical thrombolysis. However, in the absence of randomized controlled trials; there is no concrete evidence of the safety and efficacy of either of these modalities. Limited study series disclosed that decompression surgery in malignant CVT can be life saving and provides good neurological outcome in some cases. Conclusion. Overall therapeutics for CVT need larger randomized controlled trials. Anticoagulaion with heparin is the only modality with a reasonable evidence to support its use in CVT. Endovascular thrombolysis and mechanical thrombectomy are reserved for selected cases who fail anticoagulation and decompression surgery for malignant CVT with impending herniation.http://dx.doi.org/10.4061/2010/956302 |
| spellingShingle | Maria Khan Ayeesha Kamran Kamal Mohammad Wasay Controversies of Treatment Modalities for Cerebral Venous Thrombosis Stroke Research and Treatment |
| title | Controversies of Treatment Modalities for Cerebral Venous Thrombosis |
| title_full | Controversies of Treatment Modalities for Cerebral Venous Thrombosis |
| title_fullStr | Controversies of Treatment Modalities for Cerebral Venous Thrombosis |
| title_full_unstemmed | Controversies of Treatment Modalities for Cerebral Venous Thrombosis |
| title_short | Controversies of Treatment Modalities for Cerebral Venous Thrombosis |
| title_sort | controversies of treatment modalities for cerebral venous thrombosis |
| url | http://dx.doi.org/10.4061/2010/956302 |
| work_keys_str_mv | AT mariakhan controversiesoftreatmentmodalitiesforcerebralvenousthrombosis AT ayeeshakamrankamal controversiesoftreatmentmodalitiesforcerebralvenousthrombosis AT mohammadwasay controversiesoftreatmentmodalitiesforcerebralvenousthrombosis |