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(Stroke. 2004;35:2428.)
© 2004 American Heart Association, Inc.

Cochrane Corner

Thrombolysis for Cerebral Vein and Dural Sinus Thrombosis

Alfonso Ciccone, MD; Patrícia Canhão, MD; Filipa Falcão, MD; José M. Ferro, MD Roberto Sterzi, MD

From the Stroke Unit (A.C.), "Niguarda Ca’ Granda" Hospital, Milan, Italy; the Department of Neurology (P.C., J.M.F.), "Santa Maria" Hospital, Lisboa, Portugal; the Service of Neurology (F.F.), "Rainha Santa Isabel" Hospital, Torres Novas, Portugal; and the Department of Neurology (R.S.), "Sant’ Anna" Hospital, Como, Italy.

Correspondence to Dr Alfonso Ciccone, Stroke Unit-Neurologia Padiglione DEA, Ospedale Niguarda Ca’, Granda Piazza Ospedale Maggiore 3, Milano, Italy 20162. E-mail alfonso.ciccone@pmp.it

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

There is no definite evidence for the best treatment for cerebral vein and dural sinus thrombosis (CVDST). The rarity and heterogeneity of clinical presentation of the disease contribute to the scarcity of therapeutic trials and to the uncertainty on the best therapeutic approach. Anticoagulants are widely used as first line therapy, their rationale being to avoid thrombus extension and favor spontaneous thrombus dissolution. Thrombolysis is considered when a rapid recanalization is sought, especially in patients who deteriorate despite anticoagulant therapy.

Objective

The aim of this study was to assess the efficacy and the safety of thrombolytics in the treatment of CVDST. The outcomes investigated were complete recovery and death. Complete recovery was considered a clinically relevant outcome for a disease with a general good prognosis. Death was considered important as well if thrombolysis is delivered to patients who deteriorate. Symptomatic intracranial hemorrhages with clinical deterioration or death and major extracranial hemorrhages requiring medical interventions or causing permanent deficiency were considered as a measure of safety.

Search Strategy
We searched the Cochrane Stroke Group Trials Register (last searched March 2003), the Cochrane Central Register of Controlled Trials (Cochrane Library, 2003, Issue 1), MEDLINE (1966 to March 2003) and EMBASE (1980 to March 2003). Reference lists of all relevant publications were screened.

Selection Criteria
Selection criteria included randomized controlled trials (RCTs) that used any thrombolytic agent, independently of duration, dosage, and route of administration, for treatment of CVDST. We defined CVDST as a symptomatic clinical condition with the demonstration of vein/sinus thrombosis by magnetic resonance . . . [Full Text of this Article]

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