Prophylactic anticoagulation with UF or LMWH is
appropriate 24h after initial evaluation if follow-up computed tomography scans
and clinical neurological examinations do not show progression. Refer to Neurosurgery Service note, call if needed. In patients
with hemorrhagic stroke, a meta-analysis indicated that chemical prophylaxis
reduces PE significantly but is associated with an insignificant reduction in
mortality and insignificant increase in hematoma size.
Consider dosing modification in small adults.
Schaible EV et al. Anticoagulation in patients with traumatic brain injury.
Curr Opin Anaesthesiol.
2013 Aug 19.
Paciaroni M et al. Efficacy and safety of anticoagulants in the
prevention of venous thromboembolism in patients with acute cerebral
hemorrhage: a meta-analysis of controlled studies. J Thromb Haemost. 2011 May;9(5):893-8.
