Abstract
Aim
The aim of the following study is to study the incidence, clinical presentations,
risk factors and management modalities in deep vein thrombosis (DVT) affecting patients
undergoing cranial or spinal surgery in neurosurgical intensive care unit (ICU).
Materials and Methods
Retrospective review of patients who developed DVT in the course of prolonged ICU
stay (>7 days), following cranial or spinal surgery between September 2009 and November
2011.
Results
A total of 260 patients were reviewed in the study period between September 2009 and
November 2011. Eight patients (3.7%) were diagnosed with DVT by color Doppler during
this period. The average age of the group was 47 years (range 36-70 years). 3 patients
had DVT limited to the popliteal vein, 2 patients had an extension to the femoral
vein and in 3 patients to the common iliac vein. Risk factors associated with DVT
seen in our series included poor neurological status with immobilization in 2 patients,
delayed ambulation in 3 patients, surgery in the prone position in 3 patients and
old age in 1 patient.
Conclusion
Prolong intraoperative time; post-operative long immobilization and old age are significant
contributory risk factor for DVT. However, this complication can be averted by prophylactic
measures like compression stockings and intermittent compression devices used in conjunction
with low molecular weight heparin and low-dose unfractionated heparin.
Key words
Deep vein thrombosis - heparin - intracranial hematoma - neurosurgical intensive care
- thromboembolism
