title: Risk of venous thromboembolism in pediatric patients with brain tumors.
abstract: BACKGROUND
  Venous thromboembolism (VTE) is a common event in adults with malignant brain tumors approaching 24% throughout the course of the disease. The high morbidity and mortality of this complication yielded several protocols for prevention of the disease in adults undergoing neurosurgery for brain tumors and possible primary prevention afterwards. We investigated the incidence and complications of VTE in pediatric neuro-oncology patients.
  
  
  METHODS
  We analyzed, retrospectively, the files of all consecutive patients under the age of 18 years who were hospitalized for the treatment of brain tumors between the years 1990 and 2003 in two leading, closely related, Israeli neuro-oncology centers.
  
  
  RESULTS
  A total of 462 children were analyzed. Three hundred eighty-four patients underwent surgery and 78 were treated medically. Only three (0.64%) of the patients developed clinical episodes of VTE that were treated conservatively. Two of these patients developed intracranial bleeding while on secondary prevention for the disease.
  
  
  CONCLUSIONS
  Although this study has considerable limitations in terms of retrospective design, heterogeneous group of patients and diagnoses, the changing awareness for thrombosis over the last 14 years and the inclusion of symptomatic VTE events only, our surprising data suggest that, as opposed to adults, the risk of clinically significant VTE in children with brain tumors may be exceedingly low. These findings set the stage for future forthcoming evaluations in view of the prospective studies that were done in adults and the possible significant implications for the prevention and possible etiologies of the disease.
authors.affiliation: Pediatric Hemato-oncology, Danna Childrens Hospital, Tel Aviv, Israel. uri.tabori@sickkids.ca
authors.forename: Uri
authors.initials: U
authors.lastname: Tabori
authors.forename: Liana
authors.initials: L
authors.lastname: Beni-Adani
authors.forename: Rina
authors.initials: R
authors.lastname: Dvir
authors.forename: Yoav
authors.initials: Y
authors.lastname: Burstein
authors.forename: Zeev
authors.initials: Z
authors.lastname: Feldman
authors.forename: Itai
authors.initials: I
authors.lastname: Pessach
authors.forename: Gideon
authors.initials: G
authors.lastname: Rechavi
authors.forename: Shlomi
authors.initials: S
authors.lastname: Constantini
authors.forename: Amos
authors.initials: A
authors.lastname: Toren
mesh_terms: D001932:Brain Neoplasms / Q000150:complications* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology*; D016896:Treatment Outcome