Thrombolysis or Anticoagulation for Cerebral Venous Thrombosis

Exclusion Criteria

• •Age less than 18 years
• •Duration from diagnosis to randomization of more than 10 days
• •Recurrent CVT
• •Any thrombolytic therapy within last 7 days
• •Pregnancy (women in the puerperium may be included)
• •Isolated cavernous sinus thrombosis
• •Isolated intracranial hypertension (without focal neurological signs, with the exception of papilloedema and 6th cranial nerve palsy)
• •Cerebellar venous thrombosis with 4th ventricle compression and hydrocephalus, which requires surgery
• •Contraindication for anti-coagulant or thrombolytic treatment
• •1. documented generalized bleeding disorder
• •2. concurrent thrombocytopenia (\<100 x 10E9/L)
• •3. documented severe hepatic or renal dysfunction, that interferes with normal coagulation
• •4. uncontrolled severe hypertension (diastolic \> 120 mm Hg)
• •5. known recent (\< 3 months) gastrointestinal tract hemorrhage (not including he¬morrhage from rectal hemorrhoids)
• •Any known associated condition (such as terminal cancer) with a poor short term (1 year) prognosis independent of CVT
• •Clinical and radiological signs of impending transtentorial herniation due to large space-occupying lesions (e.g. large cerebral venous infarcts or hemorrhages)
• •Recent (\< 2 weeks) major surgical procedure (does not include lumbar puncture) or severe cranial trauma
• •Known allergy against contrast fluid used during endovascular procedures or the thrombolytic drug used in that particular centre
• •Previously legally incompetent prior to CVT
• •No informed consent