The benefit of compression stockings is unclear, though they are frequently used. Physical activity
Inactivity is contraindicated in the aftermath of an SVT. Uninterrupted periods of sitting or standing may cause the SVT to elongate from its point of origin, increasing the risk for complications and clinical worsening. Medications
Medications used for the treatment of SVT include anticoagulants, NSAIDs (except aspirin), antibiotics, and corticosteroids. Anticoagulants
SVTs that occur within the great saphenous vein within 3 cm of the saphenofemoral junction are considered to be equivalent in risk to DVTs. These high risk SVTs are treated identically with therapeutic anticoagulation. Anticoagulation is also used for intermediate risk SVTs that are greater than 3 cm from the saphenofemoral junction or are greater than 4–5 cm in length.Anticoagulation for high risk SVTs includes the use of vitamin K antagonists or novel oral anticoagulants (NOACs) for 3 months. Anticoagulation for intermediate risk SVTs includes fondaparinux 2.5 mg daily for 45 days or the use of intermediate to therapeutic dose low molecular weight heparin for 4–6 weeks. NSAIDs
NSAIDs (non-steroidal anti-inflammatory drugs) can be used in both oral or topical formulations for the relief of SVT symptoms. The British Committee for Standards in Haematology guidelines recommend the use of NSAIDs for low-risk SVTs (thrombus <4–5 cm in length, no additional risk factors for thromboembolic events). NSAIDs are used for treatment durations of 8–12 days. Other
Antibiotics are used in the treatment of septic SVT. Corticosteroids are used for the treatment of SVTs in the setting of vasculitic and autoimmune syndromes.
Cerebral venous sinus thrombosis (CVST), cerebral venous and sinus thrombosis or cerebral venous thrombosis (CVT), is the presence of a blood clot in the dural venous sinuses (which drain blood from the brain), the cerebral veins, or both. Symptoms may include severe headache, visual symptoms, any of the symptoms of stroke such as weakness of the face and limbs on one side of the body, and seizures, which occur in around 40% of patients.The diagnosis is usually by computed tomography (CT scan) or magnetic resonance imaging (MRI) to demonstrate obstruction of the venous sinuses. After confirmation of the diagnosis, investigations may be performed to determine the underlying cause, especially if one is not readily apparent. Treatment is typically with anticoagulants (medications that suppress blood clotting) such as low molecular weight heparin. Rarely, thrombolysis (enzymatic destruction of the blood clot) or mechanical thrombectomy is used, although evidence for this therapy is limited. The disease may be complicated by raised intracranial pressure, which may warrant surgical intervention such as the placement of a shunt. Signs and symptoms
Nine in ten people with cerebral venous thrombosis have a headache; this tends to worsen over the period of several days, but may also develop suddenly (thunderclap headache). The headache may be the only symptom. Many have symptoms of stroke: inability to move one or more limbs, weakness on one side of the face or difficulty speaking.