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What additional testing besides LAC/APLS, factor V Leiden, prothrombin gene mutation, JAK 2 do you draw for unprovoked cerebral venous sinus thrombosis?

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What workup would you perform for unprovoked CVST?

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1 Answer
Mednet MemberInvited Expert
Hematology · The Mass General Porphyria Center
Answered on

Cerebral venous sinus thromboses (CVST) are often put into the category of "thromboses of unusual sites,"--as opposed to the more common lower extremity thromboses or pulmonary emboli.

Provoked causes of CVST include pregnancy or exogenous estrogen use, infection of the head/neck or CNS, head trauma, and malignancy. CVST is more common in women than men (3:1) and in younger patients (Riva and Ageno, PMID 32164214, Mathew and Zumberg, PMID 34889361).

In patients with truly unprovoked CVST, I typically check a complete inherited and acquired thrombophilia panel (though one might argue that aside from antiphospholipid antibodies, results are unlikely to change management). This includes FVL, prothrombin gene mutation, protein C, protein S, antit...

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