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Topics:
Pediatric Hematology/Oncology • Thrombosis • Hematology • Pediatric Hematology • Benign Hematology • Hemostasis/Thrombosis • Neurology • Vascular Neurology
What would you recommend for long term management of extensive dural venous sinus thrombosis (CVST) in young females when the only provoking risk factor is combined OCP?
Thrombophilia testing, including JAK2 is negative. When would you stop anticoagulation?
Answer from: at Academic Institution
From a Vascular Neurology perspective, there are two considerations when faced with patients with venous sinus thrombosis. First is the status of the intracranial venous circulation and whether or not there has been adequate reconstitution of venous outflow, either through recanalization or collater...
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Answer from: at Academic Institution
I would anticoagulate initially with a DOAC or warfarin. I would do follow-up imaging in 3-6 months, and if the CVST was significantly improved, switch to aspirin. If not, continue anticoagulation for a total of 12 months, then try discontinuing in favor of aspirin, after reimaging.
Answer from: at Academic Institution
Practice guidelines from the AHA on CVT came out earlier this year:
https://www.ahajournals.org/doi/epdf/10.1161/STR.0000000000000456