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Cerebral Venous Thrombosis Not Responding to Anticoagulation 

Cerebral Venous Thrombosis Not Responding to Anticoagulation
Chapter:
Cerebral Venous Thrombosis Not Responding to Anticoagulation
Source:
Neurocritical Care (2 ed.)
Author(s):

Eelco F. M. Wijdicks

, Alejandro A. Rabinstein

, Sara E. Hocker

, and Jennifer E. Fugate

DOI:
10.1093/med/9780190602659.003.0011

Patients with cerebral venous sinus thrombosis can present deceptively normal. Many patients are not critically ill, but all are at risk for deterioration from venous infarction, intracerebral hemorrhage, cerebral edema, and seizures. These complications, in an often young patient, may be devastating if they are not recognized and followed by immediate treatment and possible endovascular intervention. This chapter addresses the related complications and treatment. Endovascular therapy should be strongly considered in a patient deteriorating from clot propagation despite adequate intravenous heparinization or use of low-molecular-weight heparin. Evacuation of a hematoma or decompressive craniectomy may be needed in a patient deteriorating from brainstem compression.

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