Long-term Prognosis in Cerebral Venous Thrombosis

Abstract

In the present series, CVT has an essentially good long-term prognosis. The frequency of long-standing epilepsy was low, suggesting that long-term anticonvulsant treatment is not necessary in the majority of cases. A second CVT or another thrombotic episode occurred in 20% of patients, stressing the need in a minority of cases for long-term anticoagulation.

Therapeutic approaches and advances in pediatric stroke

“…Consistent evidence supports ACT with heparin in adult CSVT for preventing death and improving neurological outcome, even among patients with initial evidence of bleeding. 99,100,101 Good safety profiles for LMWH, UFH, and warfarin have been documented in both neonates and children with non-hemorrhagic CSVT. 47,93,102 The Chest guidelines recommend ACT in children with CSVT and in neonates without major hemorrhage.…”

Giant, Nonfunctioning Carcinoma of the Adrenal Cortex

“…At present, however, no clinical trials support such a treatment regimen. With regard to the risk of major bleeding complications that is directly related to the duration of anticoagulant therapy, 4 we suggest restricting the initial treatment period to five years, even in these high-risk patients. Thereafter, the decision as to whether warfarin therapy should be continued or stopped should be reconsidered.…”

“…No prospective studies have adequately addressed the issue of the desirable duration of oral anticoagulant therapy in patients with cerebral-vein thrombosis. In patients whose event is unprovoked or in patients who are affected by an inherited thrombophilia, we recommend indefinite treatment because of the 17 to 26 percent rate of recurrence of cerebral or noncerebral thrombotic events, 4,5 We would like to draw attention to the importance of considering meningococcal disease in patients who present with septic arthritis and rash.…”

“…3 More recently, in a study of 51 patients, Gram's staining of biopsy or needle-aspiration specimens from skin lesions provided a diagnosis within less than an hour in patients with meningococcal septicemia. 4 Examination of the cerebrospinal fluid was inconclusive in most cases.…”

“…In particular, we would like to know how many of the patients in the two groups received an angiotensin-converting-enzyme (ACE) inhibitor, which according to the Heart Outcomes Prevention Evaluation (HOPE) trial is associated with a decrease in the incidence of diabetes mellitus. 4 To the Editor: More than two thirds of the subjects in the study by Tuomilehto et al were women, and therefore the role of gestational diabetes, a major risk factor for the subsequent development of type 2 diabetes, should not be overlooked. 1 How many women in the study had a history of gestational diabetes, and were these women equally distributed between the intervention and usual-care groups?…”