Gálvez LME, Orozco PJ, Heredia SAC, Choque AJ, Pedraza GR, Villada MM

Language: Spanish
References: 20
Page: 171-177
PDF size: 127.59 Kb.

ABSTRACT

Genetic and acquired factors are a trigger for stroke. Cerebral venous thrombosis is not a common presentation of stroke, specifically the deep venous thrombosis, usually affecting young individuals, when these factors interact they cause dynamic circulatory changes, resulting in thrombosis. Diagnosis and management of cerebral venous thrombosis is difficult because of the great diversity of predisposing conditions. Lack of adequate approaches to fibrinolytic therapy, due to the absence of multiple randomized clinical trials or meta-analyses that approve the safe use of recombinant tissue plasminogen Activator (rt-PA). Algorithm of treatment for venous thrombosis; exist through observational randomized clinical trials that approve this management giving a level of evidence for each treatment, more focused trials in the administration of unfractioned heparin, low molecular weight heparin (LMWH), and oral anticoagulation. There are very successful trials for fibrinolytic therapy, in numerous case reports and a nonrandomized trials that have shown that management with intravenous fibrinolityic therapy is relatively safe and assists in rescuing patients with progressive neurologic deficit in spite of an anticoagulation therapy with unfractioned heparin or LMWH. The management with rt-PA to a patient with deep cerebral venous thrombosis, without initial anticoagulation, showed successful response. We share this case and compare with the literature.

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