How do you manage incidentally found venous sinus thrombosis?
I would make sure first that it is not simply a congenitally small sinus. If there is truly a CVST, I would probably treat with a DOAC for 3 months and reassess with CTV.
I think it's crucial to put this into context; why was the test ordered? I'm always curious about why we would label something as incidental. Was the anatomical study ordered due to a change in mental status, new onset headaches, seizures, etc.?
Moreover, what was the immediate past medical history?...
Depending on the age, I would do a venous hypercoagulability and malignancy workup.
If you take a broad lens and look at CVST, a high proportion of those identified are incidentally discovered with imaging and not necessarily the primary (i.e., symptomatic) reason for that imaging study in the first place. Lily Zhou looked at this (Zhou et al., PMID 34645539) and although this stud...