Letter by Misra et al Regarding Article, “Anticoagulants for Cerebral Venous Thrombosis: Harmful to Patients?”

We read with interest the article by Dr Cundiff1 in which he has highlighted the harmful effect of heparin and oral anticoagulant in cerebral venous thrombosis (CVT). CVT is more common in the developing countries because of high incidence of infection, pregnancy, puerperal complications, dehydration, and hot climate. We have concerns regarding grouping of the patients in the above study. The patients in the study by Nagaraja et al2 received low-dose heparin (2500 thrice daily) have been grouped with those who did not receive heparin. In this study on 150 patients with CVT, 73 received heparin and 77 did not. Even the low-dose heparin was effective in reducing death (8 versus 18; P <0.001) and resulting in complete recovery (34 versus 14; P <0.001) compared with no heparin …