Deep-venous thrombosis of the upper extremity after traumatic brain injury.
Deep-venous thrombosis (DVT) of the lower extremity occurs frequently in a variety of patients, including those with traumatic brain injury (TBI), during their rehabilitation. Thrombosis of the major veins of the upper extremity is believed to be relatively rare, although it has increased in recent years due to the routine use of indwelling percutaneous central venous catheters. Upper extremity pain and swelling in a TBI patient is commonly attributed to heterotopic ossification, reflex sympathetic dystrophy, or occult fracture. Clinicians may not consider DVT in the differential diagnosis. No longer regarded as a benign disorder, we report the successful outcome in a 27-year-old with TBI who developed an upper extremity DVT after subclavian catheterization. The diagnostic findings, as well as treatment recommendations are reviewed.
Stone
L R
LR
Adult Brain Injury Service, Rancho Los Amigos Medical Center, Downey, CA 90242.
Keenan
M A
MA
D000328:Adult; D001367:Axillary Vein; D001930:Brain Injuries / Q000150:complications*; D002406:Catheterization, Peripheral / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D013350:Subclavian Vein; D013927:Thrombosis / Q000188:drug therapy / Q000209:etiology*; D014859:Warfarin / Q000627:therapeutic use
D014859:Warfarin; D006493:Heparin