Department of Clinical Medicine, Research Center on Thromboembolic Disorders and Antithrombotic Therapies, University of Insubria, Varese, Italy.
Intern Emerg Med. 2010 Feb;5(1):27-32. doi: 10.1007/s11739-009-0329-1. Epub 2009 Dec 1.
Advances in neuroimaging have modified our knowledge on cerebral vein thrombosis (CVT). This disease is now diagnosed more frequently, and increasing evidence as to what are the most common risk factors and on the natural history of the disease is becoming available. Most patients with CVT have a benign prognosis: only a minority of patients die during the acute phase or in the following months. Most patients surviving CVT recover completely, or have only mild functional or cognitive deficits. Unfractionated or low-molecular weight heparin is widely used as a first-line therapy of CVT, despite the absence of conclusive evidence about the safety and efficacy in this setting. Vitamin K antagonists are usually prescribed for secondary prevention, but the optimal duration of treatment remains unknown. Because most patients with CVT have partial or complete recanalization of the vessels within the first few months after the index event, and because recurrences of CVT after a first episode appear to be uncommon, routine use of long-term therapy or event life-long secondary prevention seem to be unnecessary.
神经影像学的进展改变了我们对脑静脉血栓形成（CVT）的认识。这种疾病现在的诊断更为频繁，越来越多的证据表明哪些是最常见的风险因素，以及疾病的自然史。大多数 CVT 患者预后良好：只有少数患者在急性期或随后的几个月内死亡。大多数幸存的 CVT 患者完全康复，或仅有轻度的功能或认知缺陷。未分级或低分子量肝素广泛用作 CVT 的一线治疗药物，尽管在这种情况下关于安全性和疗效的证据尚不明确。维生素 K 拮抗剂通常用于二级预防，但最佳治疗持续时间仍不清楚。因为大多数 CVT 患者在首发事件后的最初几个月内血管有部分或完全再通，并且首次发作后 CVT 的复发似乎并不常见，因此常规使用长期治疗或终生二级预防似乎没有必要。
