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(Stroke. 2003;34:1054.)
© 2003 American Heart Association, Inc.

Cochrane Corner

Anticoagulation for Cerebral Sinus Thrombosis

From the Department of Neurology, Academic Medical Centre, University of Amsterdam.

Correspondence to Prof J. Stam, Academic Medical Centre, PO Box 22700, 1100 DE Amsterdam, the Netherlands. E-mail j.stam@amc.uva.nl

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Background

Treatment of cerebral sinus thrombosis with anticoagulants has been controversial. Anticoagulants may prevent new venous infarcts, neurologic deterioration, and pulmonary embolism but may also promote hemorrhages.

Objectives

To review the available evidence regarding the effectiveness and safety of anticoagulant therapy in patients with confirmed cerebral sinus thrombosis.

Search Strategy

We searched the Cochrane Stroke Group Trials Register (last searched March 18, 2002). We also searched MEDLINE (1966 to October 2001), EMBASE (1980 to February 2002), and the Cochrane Controlled Trials Register (Cochrane Library, 2002 Issue 1) and contacted authors to identify additional published and unpublished studies.

Selection Criteria

Unconfounded randomized controlled trials in which anticoagulant therapy was compared with placebo or open control in patients with cerebral sinus thrombosis (confirmed by intra-arterial contrast or magnetic resonance angiography).

Data Collection and Analysis

Two reviewers independently extracted outcomes for each of the 2 treatment groups (anticoagulant treatment and control) and analyzed the outcome data for each patient in the treatment group to which the patient was originally allocated ("intention-to-treat" analysis). A weighted estimate of the treatment effects across trials (relative risk, absolute risk reduction) was calculated using the Cochrane statistical software.

Main Results

Two small trials involving 79 patients fulfilled the inclusion criteria. One trial (20 patients) examined the efficacy of intravenous, adjusted-dose, unfractionated heparin. The other trial (59 patients) examined high-dose, body-weight-adjusted, subcutaneous, low-molecular-weight heparin (nadroparin). Anticoagulant therapy was associated with a pooled relative risk of death of 0.33 (95% CI 0.08 to 1.21) and of death or dependency of 0.46 (95% CI 0.16 to 1.31) (the Figure). No new symptomatic . . . [Full Text of this Article]

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