What is deep vein thrombosis (DVT) in traumatic brain injury (TBI)?

Updated: Feb 01, 2018
  • Author: Percival H Pangilinan, Jr, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Answer

Deep vein thrombosis (DVT) is common in persons with TBI, with an incidence as high as 54%. [6] In patients with TBI, risk factors for DVT include immobility, lower extremity fracture, paralysis, and disruption in coagulation and fibrinolysis.

Complications of DVT include pulmonary embolism (PE), postthrombotic syndrome, and recurrence. Because DVT can result in PE, it can be critical. Given the rapid decline in pulmonary function when a PE has completely occluded the pulmonary capillary system, sudden death may be the first clinical sign. [32] Other clinical signs of PE include shortness of breath, chest pain, and pulmonary crackles; these are usually present with small emboli. However, clinical signs and symptoms are often absent in the patient with DVT. Therefore, a high index of suspicion and timely medical intervention are of utmost importance.

The most common modalities for detecting DVT are venous Doppler ultrasonography and contrast-enhanced venography. Venography remains the criterion standard for diagnosing DVT. Noninvasive Doppler ultrasonography is most commonly used because of its low risk of adverse effects compared with venography. [33]


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