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THE CLINICAL MANAGEMENT OF CEREBRAL VENOUS SINUS THROMBOSIS. A UK SURVEY
  1. Tim Lavin1,
  2. Martin Punter1,2,
  3. Mark Holland3
  1. 1 Salford Royal NHS Foundation Trust, UK
  2. 2 University of Manchester
  3. 3 University Hospital of South Manchester

Abstract

Introduction The clinical management of Cerebral Venous Sinus Thrombosis (CVST) involves low molecular weight heparin (LMWH), unfractionated heparin (UFH) or mechanical thrombectomy, followed by long term anticoagulation. We sought to establish how CVST is managed across the UK. An online survey was distributed to members of the Association of British Neurologists, British Association of Stroke Physicians and the Society of Acute Medicine There were 194 respondents.

Results The treatment choice of participants was LMWH in 85% with 9.7% opting for UFH. Respondents were confident in the use of heparin in CVST with no parenchymal changes (89%), CVST with venous infarct (84%), and CVST with venous infarct and small haemorrhages (71%). In CVST with a large haemorrhagic infarction, there was more uncertainty, with only 29.8% confident in their use. Warfarin was the choice of long term anti-coagulation in 85% with 5% considering novel anticoagulants (NOAC).

Conclusion Overall respondents were confident in the use of heparin for the treatment of CVST. Respondents used LMWH predominantly, in keeping with EFNS guidance, yet in contrast to a previous European survey.1

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