Prophylaxis against thromboembolism in neurosurgical and head injury patients

Neurosurgical patients are at great risk for venous thromboembolism. Thromboprophylaxis is either with unfractionatedheparin or low molecular weight heparin (LMWH). In neurosurgery, this is a matter of debate because of fear frombleeding. Few randomized studies show that chemical prophylaxis is safe after elective neurosurgeries. Prophylaxiswith gradual elastic stocking and venous pump may be affective but there are not enough studies and trials examiningtheir efficacy. Larger trials are needed to examine the safety of unfractionated heparin versus LMWH in neurosurgicalpatients including head injury patients