What are the guidelines on secondary stroke prevention in patients with cerebral venous sinus thrombosis?

Updated: Jan 10, 2016
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ACCP guidelines suggest anticoagulation over no anticoagulant therapy during the acute and chronic phases of cerebral venous sinus thrombosis (CVT) (grade 2C) [11]

According to the 2011 AHA/ASA CVT statement, prevention strategies for CVT are focused on venous events such as recurrence of CVT or other venous thromboembolism. Anticoagulation is the mainstay of acute treatment for CVT, and short or extended anticoagulant therapy is often used for secondary prevention after CVT, but no clinical trials have studied this use.

Because patients who have had an episode of CVT are more likely to experience new systemic venous thromboembolism than recurrent CVT CVT, it may be generally reasonable to prevent both by adopting venous thromboembolism prevention guidelines. However, the CVT statement recommends testing patients for prothrombotic conditions 2-4 weeks after completion of acute anticoagulant treatment (if they are not taking warfarin) in order to determine individual thrombosis risk. [6]

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