Safer, simpler treatment discovered for rare stroke
Breakthrough research reveals a new rare stroke treatment that’s just as safe as traditional methods but eliminates constant monitoring.
Published on February 20, 2025
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A recent international study led by Amsterdam University Medical Center (AUMC) is improving the lives of patients who suffered a rare form of stroke. The research shows that sinus thrombosis, a form of stroke that affects three or four adults in a million, can also be treated using direct oral anticoagulants (DOACs), eliminating the need for constant monitoring.
Sinus thrombosis is a rare but serious form of stroke that predominantly affects individuals under 50 years of age. In the Netherlands alone, approximately 300 cases are reported annually, with women accounting for three-quarters of all patients. This condition manifests as a blood clot in the cavernous sinuses, which are crucial blood vessels located beneath the brain and behind each eye socket. The most common symptoms include severe headaches, paralysis-like symptoms, epileptic seizures, eye swelling, double vision, and elevated temperature.
Traditional treatment approach to stroke
Historically, patients diagnosed with sinus thrombosis have been treated with vitamin K antagonists (VKAs), a type of blood thinner that requires frequent monitoring. This traditional approach necessitates regular visits to thrombosis service centers to ensure proper dosage adjustment. The treatment typically extends over several weeks, and complete recovery might take months. Without proper treatment, the condition can be life-threatening, with mortality rates reaching up to 33% even with prompt intervention.
The largest international study on sinus thrombosis in 25 years, led by Amsterdam UMC, has produced promising results. The research analyzed data from 619 patients across 23 countries and five continents, with 65% receiving DOACs and 35% receiving traditional VKAs. The study's primary focus was on safety outcomes, particularly monitoring major bleeding incidents - the main side effect of blood thinners. The results showed that both treatment groups experienced identical rates of complications, with only 3% of patients in each group developing new thrombosis or major bleeding within six months of diagnosis.
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Future implications
According to neurologist and research leader Jonathan Coutinho, these findings are expected to revolutionize treatment standards. The new DOAC medication offers the same safety and efficacy as traditional treatments while eliminating the need for frequent monitoring visits. This breakthrough is particularly significant given the condition's serious nature and its impact on younger patients. Despite the challenges posed by privacy regulations (GDPR), the successful completion of this study through international collaboration marks a significant advancement in stroke treatment.