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Treatment of deep vein thrombosis and pulmonary emboli in patients with primary and metastatic brain tumors. Anticoagulants or inferior vena cava filter?
- Source :
-
Archives of internal medicine [Arch Intern Med] 1987 Dec; Vol. 147 (12), pp. 2177-9. - Publication Year :
- 1987
-
Abstract
- There is a common belief that administration of anticoagulants to patients with brain tumors is contraindicated. Between 1982 and 1986, 50 patients with deep venous thrombosis and pulmonary emboli and brain tumors were examined and treated. Twenty-four patients received an inferior vena cava Greenfield filter and 25 patients were treated with anticoagulants. One patient was terminal and received no therapy. Patients in each group were similar with regard to age, sex, primary tumor, computed tomographic findings, and ultimate outcome. At the time of diagnosis, all patients had residual tumor and most had significant cerebral edema and midline shift. There were no complications in the group receiving Greenfield filters. One patient had a pulmonary embolus after the filter was placed and later required anticoagulant therapy. In the group receiving anticoagulants, one patient had focal intraventricular bleeding observed incidentally on computed tomographic scan one month after beginning anticoagulant therapy and was totally asymptomatic. One patient had gastrointestinal tract bleeding five days after beginning anticoagulant therapy with heparin sodium, and the therapy was therefore discontinued. No other patient had significant bleeding. In view of these findings, a reevaluation of anticoagulant therapy in patients with central nervous system tumors is warranted.
- Subjects :
- Anticoagulants adverse effects
Brain Neoplasms secondary
Gastrointestinal Hemorrhage chemically induced
Humans
Pulmonary Embolism drug therapy
Pulmonary Embolism mortality
Pulmonary Embolism therapy
Thrombophlebitis drug therapy
Thrombophlebitis mortality
Thrombophlebitis therapy
Vena Cava, Inferior
Anticoagulants therapeutic use
Brain Neoplasms complications
Hemofiltration adverse effects
Pulmonary Embolism complications
Thrombophlebitis complications
Subjects
Details
- Language :
- English
- ISSN :
- 0003-9926
- Volume :
- 147
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Archives of internal medicine
- Publication Type :
- Academic Journal
- Accession number :
- 3500686