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Management of venous thromboembolism in patients with primary and metastatic brain tumors.


Posted on: 03/14/2006

Management of venous thromboembolism in patients with primary and metastatic brain tumors.

J Clin Oncol. 2006 Mar 10;24(8):1310-8.

Gerber DE, Grossman SA, Streiff MB.

Departments of Oncology, Medicine, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.

Venous thromboembolism occurs commonly throughout the clinical course of patients with brain tumors. A number of hemostatic and clinical factors contribute to this hypercoagulable state. Concern over the possibility of intracranial bleeding has limited the use of anticoagulation in this population. However, mechanical approaches such as vena cava filters have high complication and treatment failure rates in patients with intracranial malignancies. In addition, the available data suggest that anticoagulation can be used safely and effectively in most of these patients. Patients with thrombocytopenia, recent neurosurgery, and tumor types prone to bleeding require special consideration. When intracranial hemorrhage does occur, it is often due to overanticoagulation, requiring prompt anticoagulation reversal and neurosurgical consultation.

Publication Types: Review

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