- Consider d-dimer as an adjunct in patients with high clinical suspicion for CST/SVT; however data is not yet strong enough to rule out with negative d-dimer and negative noncontrast CT head.
- CT-V or MR-V is still the gold standard for diagnosing CST/SVT.
- Pay attention to selection bias and spectrum bias in studies. You may inadvertently use sensitivities and specificities not applicable to your patient sample.
- Kosinski CM, Mull M, Schwarz M, et al. Do normal D-dimer levels reliably exclude cerebral sinus thrombosis? Stroke. 2004 Dec;35(12):2820-5.
- Crassard I, Soria C, Tzourio C, et al. A negative D-dimer assay does not rule out cerebral venous thrombosis: a series of seventy-three patients. Stroke. 2005 Aug;36(8):1716-9.