title: Low molecular weight heparin versus unfractionated heparin in cerebral venous sinus thrombosis: a randomized controlled trial.
abstract: BACKGROUND
  There is no randomized controlled trial (RCT) evaluating the efficacy and safety of low molecular weight heparin (LMWH) compared to unfractionated heparin (UFH) in cerebral venous sinus thrombosis (CVST). In this RCT, we have evaluated the efficacy and safety of LMWH versus UFH in CVST.
  
  
  METHODS
  Consecutive patients with CVST diagnosed on the basis of MR venography (MRV) who was free of bleeding diathesis, malignancy, hepatic or renal failure were prospectively enrolled. History, clinical findings and risk factors were evaluated. MRI and MRV findings were recorded. The patients were randomized to LMWH and UFH groups for 14 days followed by oral anticoagulant. The hospital mortality and 3 months outcome as assessed by Barthel index (BI) score were noted.
  
  
  RESULTS
  32 patients received UFH and 34 received LMWH. The baseline demographic, clinical and radiological parameters were similar in both the groups. Six patients died and all were in UFH group (P = 0.01). At 3 months, insignificantly higher number of patients recovered completely in LMWH compared to UFH group (30 vs. 20). There was no serious side effect needing withdrawal of drugs except one was withdrawn from UFH because of heparin-induced thrombosis.
  
  
  CONCLUSIONS
  Low molecular weight heparin resulted in significantly lower hospital mortality in CVST compared to UFH.
authors.affiliation: Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India. drukmisra@rediffmail.com
authors.forename: U K
authors.initials: UK
authors.lastname: Misra
authors.forename: J
authors.initials: J
authors.lastname: Kalita
authors.forename: S
authors.initials: S
authors.lastname: Chandra
authors.forename: B
authors.initials: B
authors.lastname: Kumar
authors.forename: V
authors.initials: V
authors.lastname: Bansal
mesh_terms: D000328:Adult; D005260:Female; D006493:Heparin / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012851:Sinus Thrombosis, Intracranial / Q000188:drug therapy* / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D006495:Heparin, Low-Molecular-Weight; D006493:Heparin