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[Thromboprophylaxis in neurosurgery and head trauma]

Abstract : The incidence of deep vein thrombosis (DVT) is between 20 and 35% using contrast venography, with a rate of symptomatic DVT between 2.3 and 6% in neurosurgery without any prophylaxis. The risk of DVT is poorly evaluated in head injured patients but is around 5%. Specific risk factors in neurosurgery are: a motor deficit, a meningioma or malignant tumour, a large tumour, age over 60 years, surgery lasting more than 4 hours, a chemotherapy. The benefit of mechanical methods or low molecular weight heparin (LMWH) for the prevention of DVP in neurosurgery is demonstrated (grade A). Each method decreases the risk by about 50%. A postoperative prophylaxis with a LMWH does not seem to increase the risk of intracranial bleeding (grade C). There is no demonstrated benefit to begin a prophylaxis with LMWH before the intervention. The duration of the prophylaxis is 7 to 10 days but this has not been scientifically determined.
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Contributor : Michel Dojat <>
Submitted on : Thursday, August 20, 2009 - 12:42:39 PM
Last modification on : Wednesday, August 19, 2020 - 12:08:05 PM




Jean-François Payen, Thierry Faillot, Gérard Audibert, Marie-Christine Vergnes, Jean-Luc Bosson, et al.. [Thromboprophylaxis in neurosurgery and head trauma]. Annales Françaises d'Anesthésie et de Réanimation, Elsevier Masson, 2005, 24 (8), pp.921-7. ⟨10.1016/j.annfar.2005.05.012⟩. ⟨inserm-00410398⟩



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