• Weilin Xu, Liansheng Gao, Tao Li, Anwen Shao, and Jianmin Zhang.
• Department of Neurosurgery, Second Affiliated Hospital, School of Medicine Brain Research Institute Collaborative Innovation Center for Brain Science, Zhejiang University, Hangzhou, Zhejiang, China.
• Medicine (Baltimore). 2018 May 1; 97 (20): e10506e10506.

Background And PurposeCerebral venous thrombosis (CVT) is a rare but life-threatening disease. Timely and proper treatments are the keys in saving patients' life and preventing from permanent neurological deficits. We performed this network meta-analysis to evaluate the role of anticoagulation in CVT, especially for the patients accompanied with hemorrhagic stroke.MethodsPubMed, Embase, Web of Science, Cochrane Database, and Chinese Biomedical (CBM) databases were searched comprehensively to select eligible articles (up to 30 June 2017). Network meta-analysis was performed based on classical frequency statistics.ResultsAround 14 studies comprising 1135 cases were included. Overall analysis showed that low-molecular weight heparin (LMWH) and unfractionated heparin (UFH) were more effective (LMWH vs placebo: OR 4.76, 95%CI: 2.56-8.33; UFH vs placebo: OR 4.12, 95%CI: 2.17-8.33), and safe (LMWH vs placebo: OR 0.22, 95%CI: 0.069-0.65; UFH vs placebo: OR 0.28, 95%CI: 0.058-0.99) than placebo in the management of CVT. Besides, LMWH showed more advantages than UFH; As for the patients accompanied with hemorrhagic stroke, LMWH and UFH were also better than placebo (efficacy: LMWH vs placebo: OR 20, 95%CI: 5.56-100; UFH vs placebo: OR 12.5, 95%CI: 3.7-33.3; safety: LMWH vs placebo: OR 0.18, 95%CI: 0.04-0.77; UFH vs placebo: OR 0.16, 95%CI: 0.04-0.6) in the management of CVT. In addition, LMWH was more effective than UFH for the patients accompanied with hemorrhagic stroke.ConclusionAnticoagulant treatment with heparin is safe and beneficial for patients with CVT, even for those accompanied with hemorrhagic stroke. Besides, LMWH is better than UFH in the management of CVT.

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