Prophylaxis of thromboembolism in the neurosurgical patient: a review

The incidence of postoperative thromboembolic complications in neurosurgical patients is 29 to 43%. However, anticoagulant treatment of these complications increases the inherent risk of hemorrhage into the operative site. We have reviewed the literature on the prophylaxis of deep vein thrombosis and pulmonary embolism; the incidence of thromboembolic complications, the mechanism of deep venous thrombosis, risk factors, and methods of prophylaxis for deep vein thrombosis are discussed in relation to possible prophylactic treatment of neurosurgical patients. We conclude from our review that low dose heparin therapy is indicated for patients undergoing elective neurosurgical procedures, especially for patients over the age of 40 and for patients under the age of 40 who are known to be at risk of developing thromboembolic complications.