Is there a Place to New Oral anticoagulants for Cerebral Venous Thrombosis?

¿Hay lugar para nuevos anticoagulantes orales para la trombosis venosa cerebral?

Resumen

Cerebral Venous Thrombosis (CVT) is an important neurologic emergency among adults, mainly in women. It is associated with
genetic or acquired risk factors, and elevated estrogen exposure stands out. The principal symptom is a headache, characterized
to be intense, progressive, and worsening with the Valsalva maneuver. The diagnosis is mostly based on D-dimer, which has a
high negative predictive value, helping to exclude the hypothesis, and magnetic resonance imaging (MRI), which can confirm the
suspicion by presenting some specific signs such as the dense triangle sign (clot inside the sinus), cord sign (thrombosed cortical or deep vein), and empty delta sign. The treatment was mostly based on unfractionated heparin (UH), low molecular weight heparin (LMWH), and Warfarin; however, now direct-acting oral anticoagulants (DOACs) are assuming an important role in this scenery.

Here we present a brief literature review searched at Pubmed and Embase concerning the best drug method to treat CVT and two
successful cases in young women patients managed with LMWH for a week, followed by a six-month treatment with Rivaroxaban.