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Low molecular weight heparin versus unfractionated heparin in cerebral venous sinus thrombosis: a randomized controlled trial
European Journal of Neurology,  Clinical Article

Misra UK et al. – Low molecular weight heparin resulted in significantly lower hospital mortality in cerebral venous sinus thrombosis (CVST) compared to unfractionated heparin (UFH).

Methods
  • Consecutive patients with CVST diagnosed on the basis of MR venography (MRV) who was free of bleeding diathesis, malignancy, hepatic or renal failure were prospectively enrolled.
  • History, clinical findings and risk factors were evaluated.
  • MRI and MRV findings were recorded.
  • The patients were randomized to LMWH and UFH groups for 14 days followed by oral anticoagulant.
  • The hospital mortality and 3 months outcome as assessed by Barthel index (BI) score were noted.

Results
  • 32 patients received UFH and 34 received LMWH.
  • The baseline demographic, clinical and radiological parameters were similar in both the groups.
  • Six patients died and all were in UFH group (P = 0.01).
  • At 3 months, insignificantly higher number of patients recovered completely in LMWH compared to UFH group (30 vs. 20).
  • There was no serious side effect needing withdrawal of drugs except one was withdrawn from UFH because of heparin-induced thrombosis.

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