Journal
CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS
Volume 18, Issue 4, Pages 393-402Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/1076029612441055
Keywords
intracerebral hemorrhage; deep vein thrombosis; pulmonary embolism; prophylaxis; therapy; low molecular weight heparin; unfractioned heparin
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Spontaneous intracerebral hemorrhage (sICH) represents a devastating clinical event with high mortality and morbidity rates. Only few patients with sICH are treated with neurosurgical evacuation of the hematoma, and the majority of them need only a good conservative medical approach. The goal of medical treatment is to avoid secondary neurological and systemic complications. Venous thromboembolism (VTE) represents one of the most feared complications of sICH, and it is a potential cause of death. The balance between the benefit of VTE prevention and the risk of hematoma enlargement and/or rebleeding with the use of pharmacologic thromboprophylaxis remains controversial because of the lack of consistent evidences in the literature. The efficacy of mechanical prophylaxis is also uncertain. Consequently, until now there are no clear guidelines and scientific evidences available for physicians in this field. The aim of this review is to analyze the available literature and guidelines about pharmacological VTE prophylaxis in patients with nonsurgical sICH.
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