{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T07:43:28Z","timestamp":1788335008984,"version":"build-2803163510"},"reference-count":42,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Thromb Hemost"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Although the entities of venous thromboembolism (VTE), deep venous thrombosis, pulmonary embolus, and thromboprophylaxis in adult patients undergoing brain tumor and spine surgery, traumatic brain injury and elective neurosurgical procedures are widely elucidated, the same is not valid when pediatric patients are under consideration. An attempt to review the peculiarities of these patients through a comprehensive bibliographic review is undertaken. We performed a narrative summary of the relevant literature dedicated to pediatric patients, centered on traumatic brain injury, the general incidence of thromboembolic disease in this patient population, the role of low molecular weight heparin (LMWH) in the treatment and prophylaxis of VTE, and its role in elective neurosurgical procedures, including spinal operations. Additionally, the risk of deep venous thrombosis in elective neurosurgical procedures is reviewed. Due to inherent limitations of the current studies, particularly a restricted number of patients, our data are underpowered to give a definitive protocol and guidelines for all the affected patients. Our current conclusions, based only on pediatric patients, argue that there is limited risk of VTE in pediatric patients suffering from brain tumors and that the possibility of VTE is very low in children undergoing elective neurosurgical procedures. There is no consensus regarding the exact incidence of VTE in traumatic brain injury patients. LMWH seems to be a safe and effective choice for the \u201cat risk\u201d pediatric patient population defined as being older than 15 years, venous catheterization, nonaccidental trauma, increased length of hospital stays, orthopaedic (including spinal) surgery, and cranial surgery.<\/jats:p>","DOI":"10.1055\/s-0041-1733959","type":"journal-article","created":{"date-parts":[[2021,10,10]],"date-time":"2021-10-10T00:33:35Z","timestamp":1633826015000},"page":"318-322","source":"Crossref","is-referenced-by-count":4,"title":["Venous Thromboembolism Risk and Thromboprophylaxis in Pediatric Neurosurgery and Spinal Injury: Current Trends and Literature Review"],"prefix":"10.1055","volume":"48","author":[{"given":"Dimitrios","family":"Panagopoulos","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Pediatric Hospital of Athens, \u201cAgia Sophia,\u201d Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ploutarchos","family":"Karydakis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, 251 Greek Air Force Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Noutsos","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pediatric Hospital of Athens, \u201cAgia Sophia,\u201d Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marios","family":"Themistocleous","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Pediatric Hospital of Athens, \u201cAgia Sophia,\u201d Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,10,8]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1007\/s00381-019-04389-5","article-title":"Incidence of venous thromboembolism in hospitalized pediatric neurosurgical patients: a retrospective 25-year institutional experience","volume":"36","author":"M A Brown","year":"2020","journal-title":"Childs Nerv Syst"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1055\/s-2003-42592","article-title":"Anticoagulation therapy in children","volume":"29","author":"S Revel-Vilk","year":"2003","journal-title":"Semin Thromb Hemost"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/S0049-3848(03)00059-8","article-title":"An open-label randomized controlled trial of low molecular weight heparin compared to heparin and coumadin for the treatment of venous thromboembolic events in children: the REVIVE trial","volume":"109","author":"P Massicotte","year":"2003","journal-title":"Thromb Res"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1097\/BPB.0000000000000053","article-title":"Risk factors for venous thromboembolism in hospitalized children and adolescents: a systemic review and pooled analysis","volume":"23","author":"S J Kim","year":"2014","journal-title":"J Pediatr Orthop B"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/j.jpeds.2011.03.052","article-title":"Pediatric venous and arterial noncerebral thromboembolism in Denmark: a nationwide population-based study","volume":"159","author":"R Tuckuviene","year":"2011","journal-title":"J Pediatr"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1067\/mpd.2001.118192","article-title":"Venous thromboembolism in childhood: a prospective two-year registry in The Netherlands","volume":"139","author":"C H van Ommen","year":"2001","journal-title":"J Pediatr"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1182\/blood.V83.5.1251.1251","article-title":"Venous thromboembolic complications (VTE) in children: first analyses of the Canadian Registry of VTE","volume":"83","author":"M Andrew","year":"1994","journal-title":"Blood"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/j.jpeds.2004.06.021","article-title":"Incidence of venous thromboembolism in infants and children: data from the National Hospital Discharge Survey","volume":"145","author":"P D Stein","year":"2004","journal-title":"J Pediatr"},{"issue":"05","key":"ref9","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1097\/TA.0000000000001404","article-title":"Evaluation of guidelines for injured children at high risk for venous thromboembolism: a prospective observational study","volume":"82","author":"R M Landisch","year":"2017","journal-title":"J Trauma Acute Care Surg"},{"issue":"07","key":"ref10","first-page":"667","article-title":"Pulmonary embolism in adolescents","volume":"140","author":"D Bernstein","year":"1986","journal-title":"Am J Dis Child"},{"key":"ref11","first-page":"766","article-title":"Mortality of patients with pulmonary embolism","volume":"114","author":"K Janata","year":"2002","journal-title":"Wien Klin Wochenschr"},{"issue":"06","key":"ref12","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/j.jpeds.2003.09.024","article-title":"Benefit and risk of heparin for maintaining peripheral venous catheters in neonates: a placebo-controlled trial","volume":"143","author":"A F Klenner","year":"2003","journal-title":"J Pediatr"},{"issue":"05","key":"ref13","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1097\/CCM.0000000000000147","article-title":"A multinational study of thromboprophylaxis practice in critically ill children","volume":"42","author":"E V Faustino","year":"2014","journal-title":"Crit Care Med"},{"issue":"06","key":"ref14","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1097\/PCC.0b013e318207124a","article-title":"Incidence and risk factors associated with venous thrombotic events in pediatric intensive care unit patients","volume":"12","author":"R A Higgerson","year":"2011","journal-title":"Pediatr Crit Care Med"},{"issue":"S 02","key":"ref15","doi-asserted-by":"crossref","first-page":"e737S","DOI":"10.1378\/chest.11-2308","article-title":"Antithrombotic therapy in neonates and children: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines","volume":"141","author":"P Monagle","year":"2012","journal-title":"Chest"},{"issue":"03","key":"ref16","doi-asserted-by":"crossref","first-page":"329","DOI":"10.3171\/2015.1.PEDS14489","article-title":"The safety and efficacy of use of low-molecular-weight heparin in pediatric neurosurgical patients","volume":"16","author":"D D Gonda","year":"2015","journal-title":"J Neurosurg Pediatr"},{"issue":"02","key":"ref17","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1097\/MBC.0b013e32835b72b8","article-title":"Dosing and monitoring of enoxaparin therapy in children: experience in a tertiary care hospital","volume":"24","author":"M M Andrade-Campos","year":"2013","journal-title":"Blood Coagul Fibrinolysis"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/S0022-3476(00)90005-2","article-title":"The use of low molecular weight heparin in pediatric patients: a prospective cohort study","volume":"136","author":"D Dix","year":"2000","journal-title":"J Pediatr"},{"issue":"04","key":"ref19","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/S0022-3476(98)70343-9","article-title":"Guidelines for antithrombotic therapy in pediatric patients","volume":"132","author":"M Andrew","year":"1998","journal-title":"J Pediatr"},{"issue":"06","key":"ref20","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1016\/j.jpedsurg.2013.02.059","article-title":"Venous thromboembolism prophylaxis in the pediatric trauma population","volume":"48","author":"A J Thompson","year":"2013","journal-title":"J Pediatr Surg"},{"issue":"S 01","key":"ref21","first-page":"32","article-title":"Deep venous thrombosis in children and adolescents","volume":"101","author":"M L Levy","year":"2004","journal-title":"J Neurosurg"},{"issue":"04","key":"ref22","doi-asserted-by":"crossref","first-page":"448","DOI":"10.3171\/2014.1.PEDS13479","article-title":"Venous thromboembolism in the setting of pediatric traumatic brain injury","volume":"13","author":"D A Harris","year":"2014","journal-title":"J Neurosurg Pediatr"},{"issue":"06","key":"ref23","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1016\/j.jpedsurg.2008.02.036","article-title":"Determination of risk factors for deep venous thrombosis in hospitalized children","volume":"43","author":"L T Vu","year":"2008","journal-title":"J Pediatr Surg"},{"issue":"06","key":"ref24","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1016\/j.jcrc.2015.07.022","article-title":"Higher-volume hypertonic saline and increased thrombotic risk in pediatric traumatic brain injury","volume":"30","author":"D L Webster","year":"2015","journal-title":"J Crit Care"},{"issue":"06","key":"ref25","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1002\/pbc.20149","article-title":"Risk of venous thromboembolism in pediatric patients with brain tumors","volume":"43","author":"U Tabori","year":"2004","journal-title":"Pediatr Blood Cancer"},{"issue":"05","key":"ref26","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1097\/00063198-200109000-00013","article-title":"Thromboembolism in brain tumors","volume":"7","author":"D C Walsh","year":"2001","journal-title":"Curr Opin Pulm Med"},{"issue":"03","key":"ref27","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1097\/00001622-200205000-00008","article-title":"Medical management of patients with brain tumors","volume":"14","author":"P Y Wen","year":"2002","journal-title":"Curr Opin Oncol"},{"issue":"03","key":"ref28","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1002\/1097-0142(20000801)89:3<640::AID-CNCR20>3.0.CO;2-E","article-title":"The risk of venous thromboembolism is increased throughout the course of malignant glioma: an evidence-based review","volume":"89","author":"L C Marras","year":"2000","journal-title":"Cancer"},{"issue":"10","key":"ref29","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1016\/S0959-8049(97)00167-6","article-title":"Incidence of risk of thromboembolism during treatment high-grade gliomas: a prospective study","volume":"33","author":"A A Brandes","year":"1997","journal-title":"Eur J Cancer"},{"issue":"12","key":"ref30","first-page":"1967","article-title":"Tissue factor, osteopontin, alphavbeta3 integrin expression in microvasculature of gliomas associated with vascular endothelial growth factor expression","volume":"82","author":"S Takano","year":"2000","journal-title":"Br J Cancer"},{"issue":"08","key":"ref31","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1097\/00001721-199912000-00002","article-title":"Pre-operative plasma levels of soluble fibrin polymers correlate with the development of deep vein thrombosis after elective neurosurgery","volume":"10","author":"F Sonaglia","year":"1999","journal-title":"Blood Coagul Fibrinolysis"},{"issue":"01","key":"ref32","doi-asserted-by":"crossref","first-page":"71","DOI":"10.3171\/2017.3.PEDS16588","article-title":"Risk of deep venous thrombosis in elective neurosurgical procedures: a prospective, Doppler ultrasound-based study in children 12 years of age or younger","volume":"20","author":"A G Scherer","year":"2017","journal-title":"J Neurosurg Pediatr"},{"issue":"02","key":"ref33","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1111\/j.1460-9592.2009.03237.x","article-title":"Screening for deep venous thrombosis after idiopathic scoliosis surgery in children: a pilot study","volume":"20","author":"O Kaabachi","year":"2010","journal-title":"Paediatr Anaesth"},{"issue":"01","key":"ref34","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/S0741-5214(96)70143-X","article-title":"A prospective study of the incidence of deep venous thrombosis in hospitalized children","volume":"24","author":"M J Rohrer","year":"1996","journal-title":"J Vasc Surg"},{"issue":"12","key":"ref35","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1001\/jamasurg.2013.3558","article-title":"Venous thromboembolism after trauma: when do children become adults?","volume":"148","author":"K J Van Arendonk","year":"2013","journal-title":"JAMA Surg"},{"issue":"06","key":"ref36","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1378\/chest.122.6.1933","article-title":"Low rate of venous thromboembolism after craniotomy for brain tumor using multimodality prophylaxis","volume":"122","author":"S Z Goldhaber","year":"2002","journal-title":"Chest"},{"issue":"04","key":"ref37","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1542\/peds.2009-0768","article-title":"Dramatic increase in venous thromboembolism in children's hospitals in the United States from 2001 to 2007","volume":"124","author":"L Raffini","year":"2009","journal-title":"Pediatrics"},{"issue":"02","key":"ref38","doi-asserted-by":"crossref","first-page":"e12","DOI":"10.1161\/CIRCULATIONAHA.105.583773","article-title":"Venous thromboembolism in children","volume":"113","author":"S Parasuraman","year":"2006","journal-title":"Circulation"},{"issue":"02","key":"ref39","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1002\/pbc.23388","article-title":"Pediatric venous thromboembolism in the United States: a tertiary care complication of chronic diseases","volume":"59","author":"B A Setty","year":"2012","journal-title":"Pediatr Blood Cancer"},{"issue":"03","key":"ref40","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/S0022-3476(96)70273-1","article-title":"Low-molecular-weight heparin in pediatric patients with thrombotic disease: a dose finding study","volume":"128","author":"P Massicotte","year":"1996","journal-title":"J Pediatr"},{"issue":"05","key":"ref41","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1097\/TA.0000000000000962","article-title":"Recommendations for venous thromboembolism prophylaxis in pediatric trauma patients: a national, multidisciplinary consensus study","volume":"80","author":"S J Hanson","year":"2016","journal-title":"J Trauma Acute Care Surg"},{"issue":"04","key":"ref42","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/j.jpedsurg.2018.09.017","article-title":"Venous thromboembolism following inpatient pediatric surgery: analysis of 153,220 patients","volume":"54","author":"B A Sherrod","year":"2019","journal-title":"J Pediatr Surg"}],"container-title":["Seminars in Thrombosis and Hemostasis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0041-1733959.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T23:42:45Z","timestamp":1649806965000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0041-1733959"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,8]]},"references-count":42,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2022,4,12]]},"published-print":{"date-parts":[[2022,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0041-1733959","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0094-6176","1098-9064"],"issn-type":[{"value":"0094-6176","type":"print"},{"value":"1098-9064","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,8]]}}}