Apixaban for the treatment of cerebral venous thrombosis: A case series.
BACKGROUND
Venous thrombosis affecting cerebral veins and sinuses (CVT) is an uncommon neurological condition. Traditionally patients are treated with intravenous heparin followed by an oral vitamin K antagonist like warfarin. Direct oral anticoagulants (DOACs) may offer advantages over warfarin. There is evidence to demonstrate the effectiveness of both dabigatran and rivaroxaban. No data, however, has been published describing the use of apixaban in patients with CVT.


METHODS
Report of three cases of CVT and review literature on available treatment options; efficacy and safety of novel oral anticoagulants in patients with systemic thrombosis.


RESULTS
All patients presented with typical features of CVT. After confirming the diagnosis, they were acutely treated with heparin and later discharged on apixaban. During follow up visits, they tolerated apixaban well and did not have any bleeding complications. Follow up scans showed resolution of the thrombus and recanalization.


CONCLUSION
CVT is an uncommon neurological condition and is often complicated by associated intraparenchymal hemorrhage. Although not recommended in current guidelines, apixaban may be a safe and effective option for the treatment of CVT.
['Rao|Shishir Keekana|SK|', 'Ibrahim|Mohammad|M|', 'Hanni|Claudia M|CM|', 'Suchdev|Kushak|K|', 'Parker|Dennis|D|', 'Rajamani|Kumar|K|', 'Mohamed|Wazim|W|']
D000284:Administration, Oral D000328:Adult D000925:Anticoagulants D002550:Cerebral Veins D005260:Female D006801:Humans D020767:Intracranial Thrombosis D008297:Male D011720:Pyrazoles D011728:Pyridones D020246:Venous Thrombosis D055815:Young Adult
Apixaban Cerebral venous thrombosis Direct oral anticoagulants Anticoagulation