The treatment and prevention of deep vein thrombosis in the preoperative management of patients who have neurologic diseases

Both the prevention and treatment of venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), can present a significant challenge to practitioners involved in the perioperative care of patients with neurologic diseases. These patients may have an increased risk of VTE due to limb paralysis, stroke, or immobility; in an acute setting, they may have a prothrombotic tendency due to release of brain tissue thromboplastin following neurologic injury. Factors such as previous VTE, malignancy, trauma, obesity, indwelling venous catheters, and hormone use may add to the overall risk. The underlying neurologic condition, the planned surgery and risk of VTE, or the presenting thrombotic event may all impact both the choice for prophylaxis and treatment.