Nirhale Satish, Rohatgi Shalesh, Rao Prajwal, Naphade Pravin, Hatekar Khushboo S
Neurology, Dr. D Y Patil Medical College, Hospital and Research Centre, Dr. D Y Patil Vidyapeeth (Deemed to be University), Pune, IND.
Cureus. 2024 Jul 17;16(7):e64744. doi: 10.7759/cureus.64744. eCollection 2024 Jul.
Cerebral venous sinus thrombosis (CVST) is a challenging condition to diagnose and treat due to its diverse range of clinical presentations. The incidence of CVST is increasing, and although diagnostic techniques have improved, the mainstay of treatment is heparin followed by vitamin K antagonist (VKA), warfarin has remained largely unchanged for the past three decades. However, new direct oral anticoagulants (NOACs) like dabigatran have been developed to address the limitations of VKA therapy. Magnetic resonance imaging (MRI) with magnetic resonance venography (MRV) is the current preferred diagnostic method for CVST due to its exceptional sensitivity and specificity. This prospective observational study was set out to investigate the efficacy and safety of dabigatran in treating cerebral venous sinus thrombosis. The study included 30 patients who reported regular intake of 150 mg dabigatran etexilate twice a day. Among the participants, headache was the most commonly reported symptom. The study found that patients treated with dabigatran experienced favorable outcomes, with all patients achieving re-canalization and reporting no major complications. These promising results suggest that dabigatran could be an effective treatment option for CVST cases. However, the study emphasizes the need for larger, multi-center studies to further validate these findings and improve the overall understanding of the condition and its treatment options.
由于临床表现多样,脑静脉窦血栓形成(CVST)的诊断和治疗颇具挑战性。CVST的发病率正在上升,尽管诊断技术有所改进,但治疗的主要方法仍是肝素,随后使用维生素K拮抗剂(VKA)华法林,在过去三十年里基本没有变化。然而,已开发出新型直接口服抗凝剂(NOACs)如达比加群,以解决VKA治疗的局限性。由于其卓越的敏感性和特异性,磁共振成像(MRI)联合磁共振静脉造影(MRV)是目前CVST首选的诊断方法。这项前瞻性观察性研究旨在调查达比加群治疗脑静脉窦血栓形成的疗效和安全性。该研究纳入了30名报告每天规律服用150毫克达比加群酯两次的患者。在参与者中,头痛是最常报告的症状。研究发现,接受达比加群治疗的患者取得了良好的结果,所有患者均实现再通且未报告重大并发症。这些有前景的结果表明,达比加群可能是CVST病例的一种有效治疗选择。然而,该研究强调需要开展更大规模的多中心研究,以进一步验证这些发现,并增进对该疾病及其治疗选择的全面了解。