Cerebral venous thrombosis: An Indian perspective

Dash, Deepa; Prasad, Kameshwar; Joseph, Leve

doi:10.4103/0028-3886.158191

Cited by 36 publications

(12 citation statements)

References 28 publications

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“…Presently, anticoagulation with hydration is the first-line treatment for CVST. Anticoagulation prevents propagation of the thrombus, hastens its spontaneous resolution, and aids in the prevention of deep vein thrombosis and embolism, without adversely promoting intracranial hemorrhage (ICH) (2, 19, 25, 38). ICH is not considered a contraindication for anticoagulation (9).…”

Section: Anticoagulation In Cvstmentioning

confidence: 99%

Role of Decompressive Craniectomy in the Management of Cerebral Venous Sinus Thrombosis

Avanali¹,

Gopalakrishnan

Devi

et al. 2019

Front. Neurol.

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Cerebral venous sinus thrombosis (CVST) is a relatively uncommon cause of stroke more often affecting women and younger individuals. Blockage of the venous outflow rapidly causes edema and space-occupying venous infarctions and it seems intuitive that decompressive craniectomy (DC) can effectively reduce intracranial pressure just like it works for malignant middle cerebral artery infarcts and traumatic brain injury. But because of the relative rarity of this type of stroke, strong evidence from randomized controlled trials that DC is a life-saving procedure is not available unlike in the latter two conditions. There is a possibility that other forms of interventions like endovascular recanalization, thrombectomy, thrombolysis, and anticoagulation, which cannot be used in established middle cerebral artery infarcts and TBI, can reverse the ongoing pathology of increasing edema in CVST. Such interventions, although presently unproven, could theoretically obviate the need for DC when used in early stages. However, in the absence of such evidence, we recommend that DC be considered early as a life-saving measure whenever there are large hemorrhagic infarcts, expanding edema, radiological, and clinical features of impending herniation. This review gives an overview of the etiology and risk factors of CVST in different patient populations and examines the effectiveness of DC and other forms of interventions.

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Section: Anticoagulation In Cvstmentioning

confidence: 99%

Role of Decompressive Craniectomy in the Management of Cerebral Venous Sinus Thrombosis

Avanali¹,

Gopalakrishnan

Devi

et al. 2019

Front. Neurol.

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“…Anticoagulation is currently the first-line treatment for CVST, and systemic anticoagulation is effective in preventing falling of the thrombus and deep vein thrombosis and embolism. 11 The 2017 European Stroke Organization guidelines for the diagnosis and treatment of CVST, endorsed by the European Academy of Neurology, recommend the following for anticoagulation therapy in patients with CVST: 12 A therapeutic dosage of heparin for all patients with acute CVST, even in the presence of intracerebral hemorrhage. Low-molecular-weight heparin over unfractionated heparin except in patients who are allergic to low-molecular-weight heparin or if rapid anticoagulant effect reversal is required.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of cerebral venous sinus thrombosis by balloon venoplasty: a case report

Chen

Shi

et al. 2021

J Int Med Res

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Cerebral venous sinus thrombosis is a special cerebrovascular disease affecting young adult and middle-aged people. The clinical manifestations of cerebral venous sinus thrombosis are diverse and nonspecific; thus, imaging plays an important role in early diagnosis. Anticoagulation with heparin is the preferred treatment for cerebral venous sinus thrombosis. Endovascular treatment is also being increasingly used to achieve recanalization of the cerebral venous sinus. We herein describe a woman in her early 50s who was diagnosed with cerebral venous sinus thrombosis for which anticoagulation with heparin was ineffective. To improve her symptoms and prognosis, we selected balloon venoplasty to treat the right sigmoid sinus thrombosis. Her condition subsequently improved, and no recurrence was observed after several follow-ups.

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“…24 Most (89.2%) observed that CVT was more common amongst young adults (< 45 years). 25 Common etiologies of CVT were: pregnancy/postpartum (42.8%), hyperhomocystienemia (31.7%), OCP usage (20%), and polycythemia (5.5%). Many (68.2%) used DOAC in treatment of CVT.…”

Section: Cerebral Venous Sinus Thrombosismentioning

confidence: 99%

Knowledge Attitudes and Practice about Stroke amongst Neurologists in India

Gupta

Dinesh

Narayan

et al. 2023

Journal of Stroke Medicine

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Background There is paucity of data regarding knowledge about diagnosis, aetiology, investigations, and management of stroke amongst neurologists in India. Methodology A cross-sectional observational analytical study in which the Knowledge, Attitudes, and Practice about stroke were assessed amongst neurologists across India using a Google Form with 30 multiple-choice questions and 10 case scenarios about acute ischemic stroke, acute hemorrhagic stroke, and cerebral venous sinus thrombosis. This Google Form was circulated amongst all Indian Academy of Neurology groups online from October 2022 to December 2022. Responses were analyzed question wise. Results A total of 148 neurologists responded with 90.5% practicing in urban India. In acute ischemic stroke only 56% chose noncontrast CT brain as the mainstay of imaging in stroke diagnosis. Similarly only 50% said that vascular imaging (CT angiography or MRI angiography) was important in stroke imaging. Questionnaires pertaining to the indications and contraindications for intravenous thrombolysis were well responded. Most answers on intracerebral hemorrhage were correct. Many neurologists are using DOAC in treatment of CVT even though latest studies have hinted towards their safety, but randomized control trials are still underway. Conclusion Results show good knowledge and practice in the field of acute hemorrhagic stroke and moderate results in CVT while there are glaring knowledge gaps in acute ischemic stroke. This reflects the rapidly changing field of acute ischemic stroke. The aim of training programs and conferences should be to update neurologists on this rapidly evolving field.

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Cerebral venous thrombosis: An Indian perspective

Cited by 36 publications

References 28 publications

Role of Decompressive Craniectomy in the Management of Cerebral Venous Sinus Thrombosis

Role of Decompressive Craniectomy in the Management of Cerebral Venous Sinus Thrombosis

Successful treatment of cerebral venous sinus thrombosis by balloon venoplasty: a case report

Knowledge Attitudes and Practice about Stroke amongst Neurologists in India

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