title: [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.
authors: Département d'anesthésie-réanimation 1, CHU de Grenoble, France.
authors: J-F
authors: JF
authors: Payen
authors: T
authors: T
authors: Faillot
authors: G
authors: G
authors: Audibert
authors: M-C
authors: MC
authors: Vergnes
authors: J-L
authors: JL
authors: Bosson
authors: B
authors: B
authors: Lestienne
authors: C
authors: C
authors: Bernard
authors: N
authors: N
authors: Bruder
mesh_terms: D006259:Craniocerebral Trauma / Q000150:complications* / Q000628:therapy; D006801:Humans; D019635:Neurosurgical Procedures; D018570:Risk Assessment; D013923:Thromboembolism / Q000517:prevention & control*