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Regarding CVST, what protocol of heparin dosing do you regularly use and does it change depending on clot burden/ICH status?

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Neurology · University of Calgary

There is very limited randomized evidence for the use of anticoagulation in any form for CVST. We often rely on extrapolations from data on the acute management of DVT in the leg and pulmonary embolus. We are mainly limited to cohort studies and small RCTs. Recent trials in this area include the TO-...

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Neurology · ChristianaCare

I agree that data on this topic is sparse. In more stable patients, the current AHA guidelines recommend LMWH over heparin gtt (see: https://www.ahajournals.org/doi/10.1161/STR.0000000000000456#:~:text=Previous%20American%20Heart%20Association%2FAmerican,the%20context%20of%20transient%20risk).

Histo...

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Neurology · University of Virginia, School of Medicine

I agree that data on this topic is sparse. In very high-risk patients without a sizeable hemorrhage, I usually use a bolus (if starting on a heparin drip). My reasoning is: usually, the flow in venous channels is slow, and due to thrombus formation that further increases resistance to f...

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