How to treat cerebral venous and sinus thrombosis

J Thromb Haemost. 2010 May;8(5):877-83. doi: 10.1111/j.1538-7836.2010.03799.x. Epub 2010 Feb 9.


Cerebral venous and sinus thrombosis (CVT) is a rare form of thrombosis, with many different clinical manifestations. Better imaging techniques have greatly improved the diagnosis, but as a result of the paucity of controlled trials, choosing the optimal treatment for each patient often remains a challenge. Heparin is generally considered the mainstay of treatment, supported by data from a few small trials. More invasive treatment options are available, such as endovascular thrombolysis and--in more severe cases--decompressive hemicraniectomy. Furthermore, CVT is often accompanied by various neurological complications, such as seizures and intracranial hypertension, which require specific treatment. In this review we summarize the available treatment options for CVT and suggest which therapy should be reserved for which patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anticoagulants / therapeutic use*
  • Cerebral Veins / pathology*
  • Heparin / therapeutic use*
  • Humans
  • Magnetic Resonance Imaging
  • Sinus Thrombosis, Intracranial / drug therapy
  • Sinus Thrombosis, Intracranial / surgery
  • Sinus Thrombosis, Intracranial / therapy*


  • Anticoagulants
  • Heparin