UMEM Educational Pearls

Category: Neurology

Title: Anticoagulation in Cerebral Venous Thrombosis

Keywords: cerebral venous thrombosis, CVT, anticoagulation, low molecular weight heparin, LMWH, UFH (PubMed Search)

Posted: 8/8/2018 by WanTsu Wendy Chang, MD
Click here to contact WanTsu Wendy Chang, MD

  • Anticoagulation is the mainstay for treatment of acute cerebral venous thrombosis (CVT) to prevent clot propagation, recanalize occluded veins and sinuses, and prevent new venous thrombosis.
  • A recent meta-analysis of 4 RCTs compared the efficacy and safety of low molecular weight heparin (LMWH) vs. unfractionated heparin (UFH) for the treatment of CVT.
  • All studies were small, with 20 to 66 patients each.
  • Treatment with LMWH compared with UFH had similar mortality (OR 0.21; 95% CI 0.02-2.44; p=0.21) and disability (OR 0.5; 95% CI 0.11-2.23; p=0.36). 

Bottom Line: LMWH appear to be similar in efficacy and safety compared with UFH for the management of CVT.


Al Rawahi B, Almegren M, Carrier M. The efficacy and safety of anticoagulation in cerebral vein thrombosis: a systematic review and meta-analysis. Thromb Res 2018;169:135-9. [Epub ahead of print] 

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