Intracranial venous sinus thrombosis: Medical and surgical management considerations

Abstract

Cerebral venous thrombosis is a serious neurological condition characterized by thrombus formation in the venous sinuses or cerebral veins. Although rare, it is a potentially fatal condition that requires prompt diagnosis and treatment. This review aims to present the most current trends in our understanding of CVT risk factors, diagnosis, medical management, role of endovascular management, risk of intracranial hemorrhage, and emerging therapies. Most cases of CVT are diagnosed by clinical features and neuroimaging suggestive of sinus occlusion. While anticoagulation with heparin is the mainstay of medical management, direct-oral anticoagulants are emerging as a potential alternative, and severe cases have been managed successfully with thrombectomy and/or intrasinus urokinase thrombolysis. Despite recent advances in anticoagulation therapy and diagnostics, larger randomized studies are required to adequately assess these emerging therapies and better inform the management of patients suffering from CVT.