scholarly journals Unfractionated or Low–Molecular Weight Heparin for the Treatment of Cerebral Venous Thrombosis

Stroke ◽  
2010 ◽  
Vol 41 (11) ◽  
pp. 2575-2580 ◽  
Author(s):  
Jonathan M. Coutinho ◽  
José M. Ferro ◽  
Patrícia Canhão ◽  
Fernando Barinagarrementeria ◽  
Marie-Germaine Bousser ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight

scholarly journals Cerebral Venous Thrombosis after a Cesarean Delivery

2010 ◽  
Vol 53 (2) ◽  
pp. 109-113 ◽  
Author(s):  
Edvard Ehler ◽  
Aleš Kopal ◽  
Milan Mrklovský ◽  
Milan Košťál
Keyword(s):  
Risk Factors ◽  
Molecular Weight ◽  
Venous Thrombosis ◽  
Cesarean Delivery ◽  
Cerebral Venous Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Methylenetetrahydrofolate Reductase ◽  
Low Molecular Weight ◽  
Viii Level ◽  
Risk Patients

Cerebral venous thrombosis (CVT) is a serious condition affecting mostly women. This report concerns two cases of women who developed CVT within 14 days of cesarean delivery. Magnetic resonance angiography of the brain (venous phase) is the best modality to diagnose the condition, and parenteral application of low-molecular-weight heparin is the most beneficial treatment. The first patient was found to have an elevated factor VIII level. In the second patient, homozygosity of the C677T mutation in the 5,10-methylenetetrahydrofolate reductase gene was found. The puerperal period and Cesarean Section (CS) are risk factors for thrombotic complications, including CVT. It is necessary to search for risk factors in a patient’s history and within the group of at-risk patients to prolong preventive administration of low molecular weight heparin (LMWH). CVT (including puerperium related) is not a detrimental to future pregnancies.

scholarly journals Cerebral venous thrombosis: An experience with anticoagulation with low molecular weight heparin

2005 ◽  
Vol 9 (1) ◽  
pp. 14-18 ◽  
Author(s):  
Lalitha V. Pillai ◽  
Dhananjay P. Ambike ◽  
Satish Nirhale ◽  
S. M. K. Husainy ◽  
Satish Pataskar
Keyword(s):  
Molecular Weight ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight

scholarly journals Antithrombotic Strategy in Cerebral Venous Thrombosis: Differences Between Neurologist and Hematologist Respondents in a Canadian Survey

2016 ◽  
Vol 44 (1) ◽  
pp. 116-119 ◽  
Author(s):  
Thalia S. Field ◽  
Marie-Christine Camden ◽  
Sohaila Al-Shimemeri ◽  
Gary Lui ◽  
Agnes Y.Y. Lee
Keyword(s):  
Molecular Weight ◽  
Venous Thrombosis ◽  
Unfractionated Heparin ◽  
Cerebral Venous Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Response Rate ◽  
Low Molecular Weight ◽  
Clinical Equipoise ◽  
First Line ◽  
Patterns Of Practice

AbstractPatterns of practice for management of cerebral venous thrombosis in Canada are unknown. We surveyed Canadian neurologists and hematologists regarding anticoagulation in cerebral venous thrombosis. The response rate was 28%, with 27 neurologists and 20 hematologists responding. We found that choice of first-line initial anticoagulation differed significantly between neurologists and hematologists, with 89% of neurologists favouring unfractionated heparin and hematologists’ preference split between unfractionated heparin (50%) and low-molecular-weight heparin (50%). Differences in patterns of practice likely reflect clinical equipoise.

scholarly journals Cerebral venous thrombosis in women of childbearing age: diagnosis, treatment, and prophylaxis during a future pregnancy

2020 ◽  
Vol 13 ◽  
pp. 175628642094516
Author(s):  
Büșra Durmuș ◽  
Laetitia Yperzeele ◽  
Susanna M Zuurbier
Keyword(s):  
Molecular Weight ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Hormone Replacement ◽  
Thrombosis Prophylaxis ◽  
Low Molecular Weight ◽  
Optimal Dosage ◽  
Childbearing Age ◽  
History Of

Sex-specific risk factors for cerebral venous thrombosis (CVT) in women include oral contraceptives, pregnancy, puerperium, and hormone replacement therapy. The acute treatment of CVT is anticoagulation using therapeutic doses of low molecular weight heparin, which is also the preferred treatment in the post-acute phase in pregnancy and during breastfeeding. In patients with imminent brain herniation decompressive surgery is probably life-saving. A medical history of CVT alone is not a contraindication for future pregnancies. The optimal dosage of low molecular weight heparin as thrombosis prophylaxis during future pregnancies after a history of venous thrombosis including CVT is the topic of an ongoing trial.

scholarly journals European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis – Endorsed by the European Academy of Neurology

2017 ◽  
Vol 2 (3) ◽  
pp. 195-221 ◽  
Author(s):  
José M Ferro ◽  
Marie-Germaine Bousser ◽  
Patrícia Canhão ◽  
Jonathan M Coutinho ◽  
Isabelle Crassard ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Venous Thrombosis ◽  
Acute Phase ◽  
Cerebral Venous Thrombosis ◽  
Evaluation System ◽  
Low Molecular Weight Heparin ◽  
Oral Anticoagulants ◽  
Experimental Studies ◽  
Low Molecular Weight

The current proposal for cerebral venous thrombosis guideline followed the Grading of Recommendations, Assessment, Development, and Evaluation system, formulating relevant diagnostic and treatment questions, performing systematic reviews of all available evidence and writing recommendations and deciding on their strength on an explicit and transparent manner, based on the quality of available scientific evidence. The guideline addresses both diagnostic and therapeutic topics. We suggest using magnetic resonance or computed tomography angiography for confirming the diagnosis of cerebral venous thrombosis and not screening patients with cerebral venous thrombosis routinely for thrombophilia or cancer. We recommend parenteral anticoagulation in acute cerebral venous thrombosis and decompressive surgery to prevent death due to brain herniation. We suggest to use preferentially low-molecular weight heparin in the acute phase and not using direct oral anticoagulants. We suggest not using steroids and acetazolamide to reduce death or dependency. We suggest using antiepileptics in patients with an early seizure and supratentorial lesions to prevent further early seizures. We could not make recommendations due to very poor quality of evidence concerning duration of anticoagulation after the acute phase, thrombolysis and/or thrombectomy, therapeutic lumbar puncture, and prevention of remote seizures with antiepileptic drugs. We suggest that in women who suffered a previous cerebral venous thrombosis, contraceptives containing oestrogens should be avoided. We suggest that subsequent pregnancies are safe, but use of prophylactic low-molecular weight heparin should be considered throughout pregnancy and puerperium. Multicentre observational and experimental studies are needed to increase the level of evidence supporting recommendations on the diagnosis and management of cerebral venous thrombosis.

Markers of Hemostatic System Activation in Acute Deep Venous Thrombosis-Evolution during the First Days of Heparin Treatment

1993 ◽  
Vol 70 (06) ◽  
pp. 0909-0914 ◽  
Author(s):  
Keyword(s):  
Molecular Weight ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Unfractionated Heparin ◽  
Low Molecular Weight Heparin ◽  
Factor Xa ◽  
Low Molecular Weight ◽  
Dose Adaptation ◽  
Heparin Treatment ◽  
Lung Scan

SummaryFibrin D-Dimer (D-Di), prothrombin activation fragment (F 1+2) and thrombin-antithrombin III complexes (TAT) were measured using ELISA procedures in the plasma of patients with an acute deep venous thrombosis (DVT), at presentation and on days 2, 6 and 10 after initiation of heparin treatment. Patients were randomly allocated into two treatment groups: 44 patients received adapted doses of continuous intravenous unfractionated heparin (UH) whereas 47 received 1 mg/kg every twelve hours of a low molecular weight heparin (enoxaparin) subcutaneously. A phlebography and a perfusion lung scan were performed before inclusion and on day 10. Failure of therapy (n = 9) was defined by venogram worsening or confirmed pulmonary embolism. Improvement (n = 44) or stationary state (n = 38) were defined by venogram evolution in the absence of new leg scan defects.At presentation, D-Di, F 1 + 2 and TAT were above cut-off values in 97, 66 and 89% of patients respectively. D-Di levels correlated with the extent of venous thrombosis whereas TAT and F 1 + 2 did not. Mean levels of D-Di decreased sharply during the first days of treatment but were still abnormal on day 10. A secondary increase of D-Di on days 6 or 10 by more than 3 μg/ml occurred in 4 of the 9 patients who developed a thromboembolic recurrence but in none of the 72 patients who had a more favorable outcome. F 1 + 2 and TAT time-courses were not related to clinical evolution. In the Enoxaparin group, there was no relationship between antifactor Xa activities and any biological markers. TAT and F 1 + 2 levels fell on day 2 and remained stable until day 10. In contrast, in the UH group, TAT and F 1 + 2 did not significantly decrease on day 2, probably due to a delay in dose adaptation, but they declined slowly until day 10.In conclusion, D-Di displays a higher sensitivity than F 1 + 2 or TAT for the diagnosis of D\T. D-Di, but not TAT or F 1 + 2, follow-up seems to be of potential value for early detection of recurrency. Hemostatic activation is controlled earlier by fixed doses of a low molecular weight heparin, irrespective of the plasma anti-factor Xa activities, than by unfractionated heparin at adapted doses.

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