Treatment variations in cerebral venous thrombosis : an international survey

Abstract

Introduction A variety of therapies are available to treat cerebral venous thrombosis (CVT), but evidence supporting the efficacy of most therapies is scarce. Heparin is considered the primary therapy [1] , but there is no consensus whether to use unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH). The ‘European Federation of Neurological Societies’ (EFNS) guideline recommends LMWH because of practical advantages and based upon data from randomized trials in leg-vein thrombosis [2] . In the ‘International Study on Cerebral Vein and Dural Sinus Thrombosis’ (ISCVT), however, UFH was used in the majority of patients [3] . Endovascular thrombolysis is generally reserved for severe cases, but no randomized trials have been performed [4] . The use of prophylactic anti-epileptic drugs (AED) in CVT is controversial [5, 6] . We hypothesized that considerable variations in treatment for CVT may exist among physicians. The aim of the present study is to determine how physicians worldwide treat CVT, using an online survey that was distributed among physicians with an interest in CVT.