Presentation on theme: "AHA/ASA This slide set was adapted from the Diagnosis and Management of Cerebral Venous Thrombosis paper This statement reflects a consensus of expert."— Presentation transcript:
0 Diagnosis and Management of Cerebral Venous Thrombosis A Statement for Healthcare Professionals from the American Heart Association/American Stroke Association Council on Stroke Gustavo Saposnik, MD, MSc, FAHA, Chair; Fernando Barinagarrementeria, MD, FAHA, FAAN; Robert D. Brown, Jr, MD, MPH, FAHA, FAAN; Cheryl D. Bushnell, MD, MHS, FAHA;Brett Cucchiara, MD, FAHA; Mary Cushman, MD, MSc, FAHA;Gabrielle deVeber, MD; Jose M. Ferro, MD, PhD; Fong Y. Tsai, MD;on behalf of the American Heart Association Stroke Council andthe Council on Epidemiology and Prevention
90 Proposed Algorithm for the Management of CVT Clinical suspicion of CVTNo evidence of CVTConsider other differential diagnosisArterial StrokeIdiopathic intracranial hypertensionMeningitisIdiopathic intracranial hypotensionBrain abscessBrain neoplasm,among othersMRI T2* weighted imaging + MRVCT/CTV if MRI not readily availableCVT (confirmed by imaging)Initiate anticoagulation (IV heparin or SC LMWH)if no major contraindicationsNeurological improvementor stableNeurological deteriorationor coma despite medical treatmentContinue oral anticoagulationfor 3-12 months or lifelong accordingto the underlying etiologya) Transient reversible factorb) Low-risk thrombophiliac) High risk/inherited thrombophilia(See section on “Long-Term Management andRecurrence of CVT”)Severe mass effect or ICHon repeated imagingNo or mild mass effecton repeated imagingMay consider decompressivehemicraniectomy(lifesaving procedure)May consider endovasculartherapy (with or withoutmechanical disruption)All patients should receive support for the prevention of complication and symptomatic therapy(eg, management of seizures, intracranial hypertension, etc.)
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