[Current controversies in the diagnosis and management of cerebral venous and dural sinus thrombosis].
Over the last few years, the results from clinical studies and innovative radiological approaches have significantly altered the management of patients with cerebral venous thrombosis. In contrast to previously held beliefs, cerebral venous thrombosis is considered to be a relatively benign disease with an overall favourable prognosis. Mortality is <10%, and the vast majority of patients recover completely. Although the efficacy of heparin has not been unequivocally proven, it is employed in most centres as the standard therapy. There are not sufficient data supporting long-term anticoagulation. In patients with a proven hypercoagulability syndrome, anticoagulation therapy is generally recommended for a period of 6 months. Whether patients with idiopathic thrombosis should also be treated remains controversial. Non-invasive MR and CT angiography techniques have largely replaced conventional angiography for initial evaluation and follow-up examinations. Both methods have a high sensitivity for cerebral venous thrombosis. Local fibrinolytic therapy or other aggressive recanalizing methods can not be generally recommended.
Schwarz
S
S
Neurologische Universitätsklinik, Klinikum Mannheim, Mannheim. s.schwarz@neuro.ma.uni-heidelberg.de
Daffertshofer
M
M
Schwarz
T
T
Georgiadis
D
D
Baumgartner
R W
RW
Hennerici
M
M
Groden
C
C
D000925:Anticoagulants / Q000627:therapeutic use; D002550:Cerebral Veins / Q000000981:diagnostic imaging; D004388:Dura Mater / Q000098:blood supply; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D020767:Intracranial Thrombosis / Q000175:diagnosis* / Q000188:drug therapy*; D008279:Magnetic Resonance Imaging; D010818:Practice Patterns, Physicians'; D012851:Sinus Thrombosis, Intracranial / Q000175:diagnosis* / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000188:drug therapy*
D000925:Anticoagulants; D006493:Heparin