Document Detail


Venous thromboembolism prophylaxis and treatment in patients with acute stroke and traumatic brain injury.
MedLine Citation:
PMID:  18388676     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Patients with acute stroke and traumatic brain injury are at risk to develop venous thromboembolism. This review analyzes the available literature to propose guidelines for the prevention and treatment of venous thromboembolism in these groups of patients. RECENT FINDINGS: In acute ischemic stroke, low-dose low-molecular-weight heparin has the best benefit-risk ratio to prevent venous thromboembolism. Patients with primary intracerebral hemorrhage and traumatic brain injury should receive intermittent pneumatic compression, followed by low-dose low-molecular-weight heparin or unfractioned heparin 3-4 days after stroke onset or 24 h after injury or surgery, respectively, and after cessation of bleeding. Concerning treatment, in patients with deep-vein thrombosis lower doses of heparin are indicated to prevent pulmonary embolism, and a vena cava filter should be considered. In patients with pulmonary embolism, treatment could be more aggressive, because of a high mortality risk. SUMMARY: Adequate prevention of venous thromboembolism with intermittent pneumatic compression or pharmacological prophylaxis is important. The best treatment of venous thromboembolism remains unclear. In case of pulmonary embolism, more aggressive treatment is warranted.
Authors:
Mervyn D I Vergouwen; Yvo B W E M Roos; Pieter W Kamphuisen
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in critical care     Volume:  14     ISSN:  1070-5295     ISO Abbreviation:  Curr Opin Crit Care     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-04     Completed Date:  2008-08-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9504454     Medline TA:  Curr Opin Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  149-55     Citation Subset:  IM    
Affiliation:
Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Anticoagulants / therapeutic use*
Brain Injuries / complications,  drug therapy*,  physiopathology
Heparin / therapeutic use
Heparin, Low-Molecular-Weight / therapeutic use
Humans
Incidence
Pulmonary Embolism / prevention & control
Stroke / complications,  drug therapy*,  physiopathology
Venous Thromboembolism / drug therapy*,  prevention & control
Venous Thrombosis / drug therapy*,  prevention & control
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Heparin, Low-Molecular-Weight; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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