Journal of Neurology

, Volume 251, Issue 1, pp 11–23

Cerebral venous and sinus thrombosis


DOI: 10.1007/s00415-004-0321-7

Cite this article as:
Masuhr, F., Mehraein, S. & Einhäupl, K. J Neurol (2004) 251: 11. doi:10.1007/s00415-004-0321-7


Cerebral venous and sinus thrombosis (CVST) can present with a variety of clinical symptoms ranging from isolated headache to deep coma. Prognosis is better than previously thought and prospective studies have reported an independent survival of more than 80% of patients. Although it may be difficult to predict recovery in an individual patient, clinical presentation on hospital admission and the results of neuroimaging investigations are—apart from the underlying condition—the most important prognostic factors. Comatose patients with intracranial haemorrhage (ICH) on admission brain scan carry the highest risk of a fatal outcome. Available treatment data from controlled trials favour the use of anticoagulation (AC) as the first-line therapy of CVST because it may reduce the risk of a fatal outcome and severe disability and does not promote ICH. A few patients deteriorate despise adequate AC which may warrant the use of more aggressive treatment modalities such as local thrombolysis. The risk of recurrence is low (< 10%) and most relapses occur within the first 12 months. Analogous to patients with extracerebral venous thrombosis, oral AC is usually continued for 3 months after idiopathic CVST and for 6–12 months in patients with inherited or acquired thrombophilia but controlled data proving the benefit of long-term AC in patients with CVST are not available.

Key words

cerebral venous thrombosis heparin thrombolysis recurrence outcome 



cerebral venous and sinus thrombosis


activated partial thromboplastin time


international units


international normalized ratio


antiepileptic drug


intracranial pressure


milliosmole per kilogram

Copyright information

© Steinkopff Verlag 2004

Authors and Affiliations

  1. 1.Dept. of NeurologyCharité Medical School, Humboldt-UniversitätBerlinGermany