Deep vein thrombosis and venous thromboembolism prophylaxis in traumatic brain injury: Current treatment options and controversies

Timothy J. Kovanda, Richard Rodgers

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Fear of hemorrhage has historically led neurosurgeons to avoid the use of anticoagulants, and thus chemical deep vein thrombosis (DVT) prophylaxis, in patients undergoing both elective and nonelective procedures. This trepidation is exacerbated in patients with traumatic brain injury (TBI) due to the possible need for emergent surgical intervention and concern for worsening intracranial hemorrhage. These concerns are justified. In a retrospective cohort study performed by Kwiatt et al., TBI patients treated prophylactically with low-molecular-weight heparin (LMWH) were more likely to demonstrate progression of intracranial hemorrhage on repeat imaging than those who were not given this medication [1]. Patients receiving LMWH in this study were also more likely to require neurosurgical intervention for hemorrhage progression.

Original languageEnglish (US)
Title of host publicationControversies in Severe Traumatic Brain Injury Management
PublisherSpringer International Publishing
Pages107-116
Number of pages10
ISBN (Electronic)9783319894775
ISBN (Print)9783319894768
DOIs
StatePublished - Jan 1 2018

Keywords

  • Deep vein thrombosis
  • Enoxaparin
  • Fondaparinux
  • Intermittent pneumatic compression
  • Prophylaxis
  • Treatment protocol
  • Unfractionated heparin
  • Venous thromboembolism

ASJC Scopus subject areas

  • Medicine(all)

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    Kovanda, T. J., & Rodgers, R. (2018). Deep vein thrombosis and venous thromboembolism prophylaxis in traumatic brain injury: Current treatment options and controversies. In Controversies in Severe Traumatic Brain Injury Management (pp. 107-116). Springer International Publishing. https://doi.org/10.1007/978-3-319-89477-5_11