Topics:
Pediatric Oncology • Hematology • Pediatric Hematology • Neurology • Neuro-critical care • Vascular Neurology • Traumatic Brain Injury
How would you manage a CVST secondary to a traumatic brain injury with the presence of intracranial hemorrhage?
When would you consider using anticoagulation and for how long?
Answer from: at Community Practice
I agree with Dr. @Choi and Dr. @Martin. Assuming we're talking about acute traumatic CVST in the acute phase of TBI with traumatic intracranial hemorrhage, I would not anticoagulate or use any other antithrombotic therapy (aside from VTE prophylaxis) unless there was evidence of venous infraction or...
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Answer from: at Community Practice
When dealing with CVST after TBI, the mechanism of injury is not the same as a spontaneous CVST. There is often direct injury to the vein or the area overlying it. Given that these patients often have other traumatic injuries, and given the lack of clear evidence to support one therapy or another, I...
Answer from: at Academic Institution
I have cautiously used intravenous heparin, with the option to stop it should there be an enlargement of the ICH. In that case, interventional clot removal might be necessary.
Answer from: at Academic Institution
Our approach is consistent with Dr. @Choi's. You rarely see clot propagation in this patient population and we will only anticoagulate, which is very rare if we feel that venous hypertension is contributing to elevated ICP. In a retrospective review of our institution's pediatric population, not a s...