Pulmonary embolism in neurosurgical patients

Pulmonary embolism continues to be a frequent cause of morbidity and mortality in neurosurgical practice. This study was designed to investigate the presence of signs and/or symptoms helpful for an early diagnosis of pulmonary embolism and to evaluate the safety of heparin treatment in neurosurgical patients.

We retrospectively reviewed 37 patients with pulmonary embolism among 6081 operated patients within the past 8 years at the Department of Neurosurgery, University of Hacettepe.

The overall incidence of pulmonary embolism was 0.42% and the mortality rate was 59.4%. The patients with cerebrovascular lesions had a significantly higher risk of pulmonary embolism compared with other neurosurgical pathologies. All patients were treated with heparin and subsequent oral warfarin therapy. None had intracranial or intraspinal bleeding while receiving anticoagulant therapy.

This study demonstrates that pulmonary embolism has a high mortality rate and heparin therapy can be used safely and without fear of intracranial or intraspinal bleeding.