Deep Vein Thrombosis Prophylaxis in the Neurosurgical Patient

The optimal approach for deep vein thrombosis (DVT) prophylaxis in the neurosurgery patient is a challenge of balancing the reduction in incidence of DVT and pulmonary embolus (PE) without risking an increase in catastrophic hemorrhages. In this article, the authors review the current literature on DVT/PE prophylaxis in neurosurgery. Mechanical and pharmacologic DVT prophylaxis strategies are discussed in terms of their efficacy in reducing DVT/PE rates as well as safety in terms of catastrophic hemorrhages. The authors offer recommendations regarding the best approach given the current state of the literature.