{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:18:11Z","timestamp":1782602291322,"version":"3.54.5"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2006,6,6]],"date-time":"2006-06-06T00:00:00Z","timestamp":1149552000000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2006,6]]},"abstract":"<jats:p>Cerebral venous and sinus thrombosis (CVST) is a rather rare disease which accounts for &lt;1% of all strokes. Diagnosis is still frequently overlooked or delayed due to the wide spectrum of clinical symptoms and the often subacute or lingering onset. Current therapeutic measures which are used in clinical practice include the use of anticoagulants such as dose\u2010adjusted intravenous heparin or body weight\u2010adjusted subcutaneous low\u2010molecular\u2010weight heparin (LMWH), the use of thrombolysis, and symptomatic therapy including control of seizures and elevated intracranial pressure. We searched MEDLINE (National Library of Medicine), the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Library to review the strength of evidence to support these interventions and the preparation of recommendations on the therapy of CVST based on the best available evidence. Review articles and book chapters were also included. Recommendations were reached by consensus. Where there was a lack of evidence, but consensus was clear we stated our opinion as good practice points. Patients with CVST without contraindications for anticoagulation should be treated either with body weight\u2010adjusted subcutaneous LMWH or dose\u2010adjusted intravenous heparin (good practice point). Concomitant intracranial haemorrhage related to CVST is not a contraindication for heparin therapy. The optimal duration of oral anticoagulation after the acute phase is unclear. Oral anticoagulation may be given for 3\u2003months if CVST was secondary to a transient risk factor, for 6\u201312\u2003months in patients with idiopathic CVST and in those with \u2018mild\u2019 hereditary thrombophilia. Indefinite anticoagulation (AC) should be considered in patients with two or more episodes of CVST and in those with one episode of CVST and \u2018severe\u2019 hereditary thrombophilia (good practice point). There is insufficient evidence to support the use of either systemic or local thrombolysis in patients with CVST. If patients deteriorate despite adequate anticoagulation and other causes of deterioration have been ruled out, thrombolysis may be a therapeutic option in selected cases, possibly in those without intracranial haemorrhage (good practice point). There are no controlled data about the risks and benefits of certain therapeutic measures to reduce an elevated intracranial pressure (with brain displacement) in patients with severe CVST. Antioedema treatment (including hyperventilation, osmotic diuretics and craniectomy) should be used as life saving interventions (good practice point).<\/jats:p>","DOI":"10.1111\/j.1468-1331.2006.01398.x","type":"journal-article","created":{"date-parts":[[2006,6,6]],"date-time":"2006-06-06T10:28:55Z","timestamp":1149589735000},"page":"553-559","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":189,"title":["EFNS guideline on the treatment of cerebral venous and sinus thrombosis"],"prefix":"10.1111","volume":"13","author":[{"given":"K.","family":"Einh\u00e4upl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.\u2010G.","family":"Bousser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. F. T. M.","family":"De Bruijn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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