What is the role of anticoagulation following a stroke with venous sinus thrombosis?

Updated: Dec 18, 2018
  • Author: Salvador Cruz-Flores, MD, MPH, FAHA, FCCM, FAAN, FACP, FANA; Chief Editor: Helmi L Lutsep, MD  more...
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Several smaller studies demonstrated that of patients with venous sinus thrombosis, those treated with full-dose heparin had better outcomes than those treated with placebo. After improvement under heparin therapy, patients usually are switched to oral anticoagulation (target INR 2.5, range 2-3).

Although the optimal duration has not been determined in randomized studies, oral anticoagulation is recommended for at least 6 months. It is unclear whether the decision to stop anticoagulation should be based on the result of angiography (magnetic resonance or conventional angiography) after 6 months. In a recent study of 33 patients placed on anticoagulation, recanalization occurred only within the first 4 months, but not thereafter.

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