Cerebral Venous Thrombosis Guidelines

Updated: Oct 09, 2018
  • Author: W Alvin McElveen, MD; Chief Editor: Helmi L Lutsep, MD  more...
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Guidelines Summary

European Stroke Organization

In 2017, the European Stroke Organization updated the previous guidelines from the European Federation of Neurological Societies. [31] Current recommendations include the following:

  • Magnetic resonance or computed tomographic angiography is recommended for confirming the diagnosis of CVT; routinely screening patients with CVT for thrombophilia or cancer is not recommended.
  • Use parenteral anticoagulation in acute CVT and decompressive surgery to prevent death due to brain herniation.
  • Use low-molecular-weight heparin in the acute phase and not direct oral anticoagulants.
  • Do not use steroids and acetazolamide to reduce death or dependency.
  • Antiepileptics are recommended in patients with an early seizure and supratentorial lesions to prevent further early seizures.
  • Avoid contraceptives containing oestrogens in women who have suffered a previous CVT.
  • Subsequent pregnancies are safe, but use of prophylactic low-molecular-weight heparin should be considered throughout pregnancy and puerperium.