Treatment of CVST includes supportive or symptomatic measures
such as hydration, appropriate antimicrobials, control
of seizures with anticonvulsants, and control of intracranial
pressure. The antithrombotic treatment modalities include
heparin, oral anticoagulants, thrombolysis and endovascular
approaches. The safety of heparin treatment has been shown
in large studies [1,6,20-22] as well as many smaller series and
case reports. The benefits of heparin were demonstrated in a
randomized and placebo-controlled trial of 20 patients [20].
There was a significant difference in favor of intravenous heparin
with respect to neurological recovery and mortality. Eight
patients in the heparin group but only one in the placebo group
recovered fully. The authors also retrospectively analyzed 102
patients with CVST, and showed that intravenous heparin was
even beneficial in those patients who had an intracranial hemorrhage
prior to starting treatment. A randomized, placebocontrolled
trial of subcutaneous low weight molecular heparin