European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis - endorsed by the European Academy of Neurology
José M. Ferro,Marie-Germaine Bousser,Patrícia Canhão,Jonathan M. Coutinho,Isabelle Crassard,Francesco Dentali,M. N. D. Di Minno,Alberto Maino,Ida Martinelli,F. Masuhr,D. Aguiar de Sousa,Jan Stam +11 more
Reads0
Chats0
TLDR
Current guidelines on cerebral venous thrombosis diagnosis and management were issued by the European Federation of Neurological Societies in 2010 are updated using a clearer and evidence‐based methodology.Abstract:
The current proposal for cerebral venous thrombosis guideline followed the Grading of Recommendations, Assessment, Development, and Evaluation system, formulating relevant diagnostic and treatment questions, performing systematic reviews of all available evidence and writing recommendations and deciding on their strength on an explicit and transparent manner, based on the quality of available scientific evidence. The guideline addresses both diagnostic and therapeutic topics. We suggest using magnetic resonance or computed tomography angiography for confirming the diagnosis of cerebral venous thrombosis and not screening patients with cerebral venous thrombosis routinely for thrombophilia or cancer. We recommend parenteral anticoagulation in acute cerebral venous thrombosis and decompressive surgery to prevent death due to brain herniation. We suggest to use preferentially low-molecular weight heparin in the acute phase and not using direct oral anticoagulants. We suggest not using steroids and acetazolamide to reduce death or dependency. We suggest using antiepileptics in patients with an early seizure and supratentorial lesions to prevent further early seizures. We could not make recommendations due to very poor quality of evidence concerning duration of anticoagulation after the acute phase, thrombolysis and/or thrombectomy, therapeutic lumbar puncture, and prevention of remote seizures with antiepileptic drugs. We suggest that in women who suffered a previous cerebral venous thrombosis, contraceptives containing oestrogens should be avoided. We suggest that subsequent pregnancies are safe, but use of prophylactic low-molecular weight heparin should be considered throughout pregnancy and puerperium. Multicentre observational and experimental studies are needed to increase the level of evidence supporting recommendations on the diagnosis and management of cerebral venous thrombosis.read more
Citations
More filters
Journal ArticleDOI
Safety and Efficacy of Dabigatran Etexilate vs Dose-Adjusted Warfarin in Patients With Cerebral Venous Thrombosis: A Randomized Clinical Trial.
José M. Ferro,Jonathan M. Coutinho,Francesco Dentali,Adam Kobayashi,Andrey Alasheev,Patrícia Canhão,Denis Karpov,Simon Nagel,Laura Posthuma,José Mário Roriz,Jorge Caria,Mandy Frässdorf,Holger Huisman,Paul A. Reilly,Hans-Christoph Diener +14 more
TL;DR: This study suggests that both dabigatran and dose-adjusted warfarin may be safe options to prevent recurrent venous thrombotic events in patients with cerebral venousThrombosis.
Journal ArticleDOI
Cerebral Venous Thrombosis: an Update
TL;DR: There is a trend in declining frequency ofCVT patients presenting with focal deficits or coma and a decrease in mortality over time, and results of recently completed randomized controlled trials on endovascular treatment and comparing dabigatran with warfarin will improve the treatment of CVT.
Journal ArticleDOI
Cerebral venous sinus thrombosis.
TL;DR: This review addresses the epidemiology, clinical presentation and course, risk factors, and treatment of cerebral venous sinus thrombosis, with a special focus on the pediatric population.
Journal ArticleDOI
Cerebral Venous Thrombosis: A Comprehensive Review
Pretty Sara Idiculla,Dhineshreddy Gurala,Manikandan Palanisamy,Rajendran Vijayakumar,Sindhu Dhandapani,Elanagan Nagarajan +5 more
TL;DR: Cerebral sinus venous thrombosis is a potentially fatal neurological condition that is often under-diagnosed due to its nonspecific presentation, and timely diagnosis and treatment can reduce morbidity and mortality.
Journal ArticleDOI
Effect of Endovascular Treatment with Medical Management vs Standard Care on Severe Cerebral Venous Thrombosis: The TO-ACT Randomized Clinical Trial
Jonathan M. Coutinho,Susanna M. Zuurbier,Marie-Germaine Bousser,Xunming Ji,Patrícia Canhão,Yvo B.W.E.M. Roos,Isabelle Crassard,Ana Paiva Nunes,Maarten Uyttenboogaart,Jian Chen,Bart J. Emmer,Stefan D. Roosendaal,Emmanuel Houdart,Jim A. Reekers,René van den Berg,Rob J. de Haan,Charles B. L. M. Majoie,José M. Ferro,Jan Stam,To-Act investigators +19 more
TL;DR: The TO-ACT trial showed that EVT with standard medical care did not appear to improve functional outcome of patients with CVT, and the possibility exists that future studies will demonstrate better recovery rates after EVT for this patient population.
References
More filters
Journal ArticleDOI
GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables
Gordon H. Guyatt,Andrew D Oxman,Elie A. Akl,Regina Kunz,Gunn Elisabeth Vist,Jan Brozek,Susan L Norris,Yngve Falck-Ytter,Paul Glasziou,Hans deBeer,Roman Jaeschke,David Rind,Joerg J Meerpohl,Philipp Dahm,Holger J. Schünemann +14 more
TL;DR: The GRADE process begins with asking an explicit question, including specification of all important outcomes, and provides explicit criteria for rating the quality of evidence that include study design, risk of bias, imprecision, inconsistency, indirectness, and magnitude of effect.
Journal ArticleDOI
GRADE guidelines: 3. Rating the quality of evidence
Howard Balshem,Mark Helfand,Mark Helfand,Holger J. Schünemann,Andrew D Oxman,Regina Kunz,Jan Brozek,Gunn Elisabeth Vist,Yngve Falck-Ytter,Joerg J Meerpohl,Susan L Norris,Gordon H. Guyatt +11 more
TL;DR: The approach of GRADE to rating quality of evidence specifies four categories-high, moderate, low, and very low-that are applied to a body of evidence, not to individual studies.
Journal ArticleDOI
Prognosis of Cerebral Vein and Dural Sinus Thrombosis: Results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT)
TL;DR: A subgroup of clinically identifiable CVT patients is at increased risk of bad outcome and may benefit from more aggressive therapeutic interventions, to be studied in randomized clinical trials.
Journal ArticleDOI
ESC Guidelines on the management of cardiovascular diseases during pregnancy: the Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC).
Vera Regitz-Zagrosek,Carina Blomström Lundqvist,Claudio Borghi,Renata Cifkova,Rafael Ferreira,Jean-Michel Foidart,J Simon R Gibbs,Christa Gohlke-Baerwolf,Bulent Gorenek,Bernard Iung,Mike Kirby,Angela H E M Maas,João Morais,Petros Nihoyannopoulos,Petronella G. Pieper,Patrizia Presbitero,Jolien W. Roos-Hesselink,Maria Schaufelberger,Ute Seeland,Lucia Torracca,Jeroen J. Bax,A Auricchio,Helmut Baumgartner,Claudio Ceconi,Veronica Dean,Christi Deaton,Robert Fagard,Christian Funck-Brentano,David Hasdai,Arno W. Hoes,Juhani Knuuti,Philippe Kolh,Theresa McDonagh,Cyril Moulin,Don Poldermans,Bogdan Alexandru Popescu,Zeljko Reiner,Udo Sechtem,Per Anton Sirnes,Adam Torbicki,Alec Vahanian,Stephan Windecker,Carlos Aguiar,Nawwar Al-Attar,Angeles Alonso Garcia,Anna Antoniou,I M Coman,Uri Elkayam,Miguel Ángel Gómez-Sánchez,Nina Gotcheva,Denise Hilfiker-Kleiner,Róbert Gábor Kiss,Anastasia Kitsiou,Karen T S Konings,Gregory Y.H. Lip,Athanasios J. Manolis,Alexandre Mebaaza,Iveta Mintale,Marie Claude Morice,Barbara J.M. Mulder,Agnes Pasquet,Susanna Price,Silvia G. Priori,Maria J Salvador,Avraham Shotan,Candice K. Silversides,Sven O Skouby,Jörg Ingolf Stein,Pilar Tornos,Niels Vejlstrup,Fiona Walker,Carole A. Warnes +71 more
TL;DR: Recommendations for the prevention and management of venous thrombo-embolism in pregnancy and puerperium and the associated risk groups according to risk factors: definition and preventive measures are presented.
Journal ArticleDOI
Diagnosis and Management of Cerebral Venous Thrombosis A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association
Gustavo Saposnik,Fernando Barinagarrementeria,Robert D. Brown,Cheryl Bushnell,Brett Cucchiara,Mary Cushman,Gabrielle deVeber,José M. Ferro,Fong Y. Tsai +8 more
TL;DR: An algorithm for diagnosis and management of patients with cerebral venous sinus thrombosis is described and evidence-based recommendations are provided for the diagnosis, management, and prevention of recurrence of cerebral venOUS thromBosis.