Sinusthrombose CCT nativ Guidelines

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Differenzierung Duraler Sinusvenenzysten und Thrombosen

Durale_Sinusvenenzyste

He summarized the main highlights of the new guidelines as follows:

Diagnostic Recommendations

  • The diagnostic recommendations are based on the impact of diagnostic procedures on patient outcome and not on process indicators.
  • For the diagnosis of CVT, computed tomographic venography, magnetic resonance venography, or intra-arterial venography can be used because these techniques have similar accuracies.
  • Prothrombotic and cancer screening are not recommended as a routine.

Therapeutic Recommendations

  • All patients with acute CVT should be anticoagulated parentally, preferably with low-molecular-weight heparin (LMWH).
  • Patients with large hemisphere lesions with impending herniation should be offered decompressive surgery.
  • Seizure prophylaxis with anticonvulsants is indicated in patients who experience an acute symptomatic seizure and have a venous infarct or hemorrhage.
  • Non–vitamin K anticoagulants (novel oral anticoagulants) are not recommended, particularly in the acute phase, because of the limited experience and unknown safety.
  • No recommendations could be made regarding acute endovascular treatment because of the very low quality of available evidence, pending the publication of the final results of the TO-ACT trial, which was prematurely terminated for futility this year.
  •  Pregnancy is not contraindicated after CVT, and subcutaneous LMWH is suggested during pregnancy to prevent recurrent venous thrombotic events.

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