Cavernous sinus thrombosis medical therapy: Difference between revisions
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Created page with "__NOTOC__ {{Cavernous sinus thrombosis}} {{CMG}} ==Overview== ==Medical Therapy== * Antithrombotics *:* Anticoagulation *:* Standard treatment at this time, even if moderat..." |
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* Antithrombotics | * Antithrombotics | ||
*:* Anticoagulation | *:* Anticoagulation | ||
*:* Standard treatment at this time, even if moderate intracranial hemorrhage present | *:* Standard treatment at this time, even if moderate [[intracranial hemorrhage]] present | ||
*:* Controversial in the past given risk of associated hemorrhage – one small randomized study with 20 patients in each arm showed a significant benefit making anticoagulation standard of care. | *:* Controversial in the past given risk of associated hemorrhage – one small randomized study with 20 patients in each arm showed a significant benefit making anticoagulation standard of care. | ||
*:* Thrombolysis – with agents like urokinase, TPA – generally given via microcatheters inserted for local infusion | *:* Thrombolysis – with agents like [[urokinase]], [[TPA]] – generally given via microcatheters inserted for local infusion | ||
*:* Initial infusion sometimes followed by continuous infusion for a day or more until clot clears. | *:* Initial infusion sometimes followed by continuous infusion for a day or more until clot clears. | ||
*:* Many case reports of success, but not standard treatment at this time. | *:* Many case reports of success, but not standard treatment at this time. | ||
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* Antibiotics – if infectious precipitant | * Antibiotics – if infectious precipitant | ||
* Intracranial pressure manipulation | * Intracranial pressure manipulation | ||
*:* Medical: mannitol, steroids, acetazolamide, repeat LPs | *:* Medical: [[mannitol]], [[steroids]], [[acetazolamide]], repeat LPs | ||
*:* Shunt | *:* Shunt | ||
Revision as of 13:59, 21 September 2012
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Cavernous sinus thrombosis Microchapters |
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Differentiating Cavernous sinus thrombosis from other Diseases |
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Cavernous sinus thrombosis medical therapy On the Web |
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American Roentgen Ray Society Images of Cavernous sinus thrombosis medical therapy |
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Risk calculators and risk factors for Cavernous sinus thrombosis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Medical Therapy
- Antithrombotics
- Anticoagulation
- Standard treatment at this time, even if moderate intracranial hemorrhage present
- Controversial in the past given risk of associated hemorrhage – one small randomized study with 20 patients in each arm showed a significant benefit making anticoagulation standard of care.
- Thrombolysis – with agents like urokinase, TPA – generally given via microcatheters inserted for local infusion
- Initial infusion sometimes followed by continuous infusion for a day or more until clot clears.
- Many case reports of success, but not standard treatment at this time.
- A study of 9 patients in Korea showed successful thrombolysis in all patients
- Risk of hemorrhage
- The literature suggests that it is mostly used now in severe cases with stupor, coma, rapidly progressing course, or severely raised ICP, and only in centers experienced in the methodology. Its role may expand with more experience.
- Surgical thrombectomy – not generally performed anymore
- Antieleptics – as indicated
- Antibiotics – if infectious precipitant
- Intracranial pressure manipulation
- Medical: mannitol, steroids, acetazolamide, repeat LPs
- Shunt