Safety and feasibility of subcutaneous low molecular weight heparin for cerebral venous sinus thrombosis.
OBJECTIVE
The effect of low molecular weight heparin (LMWH) in the management of cerebral venous thrombosis (CVT) remains unclear. The present study was performed to determine the safety and feasibility of subcutaneous LMWH, with particular attention to hemorrhagic conversions.


METHODS
LMWH (nadroparin, 7,500 ICU, every 12 hours) was administered subcutaneously for 14 days to 12 patients diagnosed with CVT. Initial clinical manifestations, etiologies and the clinical courses after LMWH treatment were also evaluated. Possible hemorrhagic side effects, including aggravation of the initial hemorrhage and/or newly developed-hemorrhagic conversions were monitored by image analysis.


RESULTS
Headaches and convulsive movements were frequent presenting symptoms for CVT. Clinical improvement was usually observed within 2 to 8 days after LMWH. Symptom stabilization was observed within 4 to 60 days. Neither clinical aggravations, nor newly developed parenchymal lesions were observed during LMWH maintenance. Associated parenchymal lesions were observed in 9 of the 12 patients, 5 of which manifested with hemorrhagic conversion, as detected by image analysis. However, no clinical and radiologic aggravation was noted in these 5 patients.


CONCLUSIONS
Our results suggest that LMWH may be safe and feasible in the management of CVT.
Kim
Ji Seon
JS
Department of Neurology, College of Medicine, Chungnam National University, Daejeon, Korea.
Jeong
Seong Hae
SH
Kim
Dae Hyun
DH
Kim
Jei
J
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