Clinically Diagnosed Postoperative Venous Thromboembolism in a Neurosurgery Practice in Nigeria

World Neurosurg. 2016 May:89:259-65. doi: 10.1016/j.wneu.2016.01.069. Epub 2016 Feb 4.

Abstract

Introduction: Postoperative venous thromboembolism (VTE) is a major surgical complication, fraught with high case fatality rate, to which neurosurgical patients are particularly prone. There is dearth of data on this problem in the neurosurgical literature from sub-Saharan Africa.

Materials and methods: A 6-year prospective descriptive study of postoperative VTE in a neurosurgeon's clinical practice in Nigeria is hereby presented. The clinical case of a fatal, postmortem-confirmed post craniotomy VTE also is annotated.

Results: There were 10 cases of clinically diagnosed neurosurgical postoperative VTE, representing 2.4% of the surgical patients population. The cases were diagnosed from clinical impressions supplemented with laboratory investigations like the Doppler ultrasonography with B-mode imaging of the deep veins of the lower extremities, and chest computed tomographic angiography. Six of these 10 cases died, a case fatality rate of 60%. Meningiomas were the intracranial tumours operated on in 60% of the cases.

Conclusions: Postoperative venous thromboembolism has a very high case fatality rate among these neurosurgical patients. There is need for continuing surveillance of this problem, as well as a heightened vigilance to prevent and treat it in our neurosurgical patient populations.

Keywords: Deep-vein thrombosis; Developing country; Neurosurgery; Postoperative; Pulmonary embolism; Venous thromboembolism.

Publication types

  • Case Reports
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Brain / diagnostic imaging
  • Brain / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Neurosurgical Procedures / adverse effects*
  • Nigeria
  • Postoperative Complications* / diagnostic imaging
  • Postoperative Complications* / mortality
  • Postoperative Complications* / pathology
  • Prospective Studies
  • Venous Thromboembolism / diagnostic imaging
  • Venous Thromboembolism / etiology*
  • Venous Thromboembolism / mortality
  • Venous Thromboembolism / pathology