• Am J Emerg Med · Aug 2017

    Case Reports

    Pharmacological management of cerebral venous sinus thrombosis with full-dose IV heparin infusion and its clinical outcomes.

    • Andrea Fernandez, Vidya Nair, Anna Mckeone, and Joseph Ho.
    • Providence St. Peter Hospital, 413 Lily Rd NE Olympia, WA 98506, United States. Electronic address: andreacamille.fernandez@providence.org.
    • Am J Emerg Med. 2017 Aug 1; 35 (8): 1208.e1-1208.e3.

    ObjectiveTo report a case of successful use of unfractionated heparin (UFH) infusion to treat cerebral venous sinus thrombosis (CVST).Case SummaryA 54-year-old female with a history of ovarian cancer addressed through palliative care, presents to the Emergency Department complaining of nausea, vomiting and headache for the last 72h. The patient was on a home regimen of enoxaparin 1.5mg/kg subcutaneously daily for recent pulmonary embolism and deep vein thrombosis that developed while on warfarin therapy previously. CT scan showed superior sagittal sinus thrombosis. UFH infusion was initiated and continued for 48h until the headache dissipated.DiscussionStable CVST may be treated with UFH infusion; however, there is limited literature that describes UFH dosing for CVST management.ConclusionsUFH may be considered as one of the pharmacological agents to manage CVST. The dosing for UFH bolus and infusion is similar to treatment dose for pulmonary embolism/deep vein thrombosis management with goal anti-Xa between 0.3 and 0.7units/mL.Copyright © 2017 Elsevier Inc. All rights reserved.

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