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Cerebral venous thrombosis - Coggle Diagram

- - - - first 5 days isointense on T1, hypointense T2
      - 5 days: hyperintense on T1 and T2
      - 1mo variable pattern of signal, max appear isointense
- - - - recanalization
      - prevent propagation to the bridging cerebral veins
      - treat prothrombotic state - prevent venous thrombosis, pulmonary emboly, recurrence of CVT
    - - sc LMWH more effective/iv unfractionated heparin UFH in adults; in children same but weaker evidence
      - not contraindications: hemorrhagic infarction, IC haemorrhage, isolated subarachnoidal hemorrhage
      - endovascular: progressive neurologic worsening despite anticoagulation - endovasular thrombolysis/thrombectomy
      - American Academy of Chest Physicians guildeine
        
        UFH/LMWH followed by LMWH/vitamin K antagonist minimum 3 months in children with CVT without IC hemorrhage; additional 3 mi if ongoing symptoms or still occlusion
        
        children with CST and hemorrhage: start with anticoagulation, neuroimaging at 5-7 days
        
        thrombolyis, thrombectomy, surgical decompression if no improvement after initital anticoagulation
      - long-term anticoagulation
        
        recurrence 5%
        
        children: vitamin K antagonists, UFH, LMWH, rivaroxaban, dabigatran
        
        duration 3-12 mo for thrombosis - depending on procoagulation, seizure profilaxis - unknown