OBJECTIVE

To identify the prevalence of venous thromboembolism (VTE) in patients with hypertensive intracerebral hematoma, aneurysmal subarachnoid hemorrhage and severe traumatic brain injury complicated by intracranial hemorrhage.

MATERIAL AND METHODS

A non-randomized retrospective observational study recruited subjects between January 2020 and May 2024 (53 months). The study group included 311 patients with various intracranial hemorrhages: hypertensive intracerebral hematoma (n=194), ruptured intracranial aneurysm with subarachnoid hemorrhage (n=41), and traumatic brain injury complicated by intracranial hemorrhage (n=76). All patients underwent ultrasound of lower limb veins upon admission or within 24 hours, and then vein patency was checked every 7 days. In case of emergency or urgent surgery, ultrasound was performed on the first postoperative day and repeated every 7 days. The diagnosis of pulmonary embolism (PE) was established using CT pulmonary angiography or autopsy data. The primary endpoints were venous thrombosis in inferior vena cava system, nonfatal and fatal PE. Secondary endpoints included recurrent intracranial hemorrhage, any other clinically significant bleedings (gastrointestinal, nasal, etc.) and death.

RESULTS

The incidence of VTE in patients with hypertensive intracerebral hematoma was 32.5% (50 patients with venous thrombosis and 13 patients with PE). Among patients with aneurysmal subarachnoid hemorrhage, the prevalence of VTE was 60.9% (21 patients with venous thrombosis and 4 patients with PE). In patients with traumatic intracranial hemorrhage, VTE was detected in 28.9% of cases (21 patients with venous thrombosis and 1 patient with PE).

CONCLUSION

VTE remains one of the main and often fatal complications of various intracranial hemorrhages. Regular ultrasound of IVC system allows timely diagnosis of venous thrombosis in patients with intracranial hemorrhage, prescription of therapeutic doses of anticoagulants and minimization of risks of fatal PE.