Summary

1. There is Level 4 evidence that forceful manipulation under general anesthesia increases range of motion in patients with heterotopic ossification following brain injury.

 

2. There is Level 2 evidence that Disodium Etidronate (EHDP) reduces the development of heterotopic ossification in patients with severe head injury.

 

3. There is Level 4 evidence that surgical excision of heterotopic ossification improves clinical outcomes.

 

4. There is Level 2 evidence from one small study to suggest that SCDs are not entirely effective in reducing the risk of developing DVT or PE post ABI.

 

5. There is Level 4 evidence that intermittent compression devices do not cause acute elevations in intracranial pressure in patients with severe ABI. 

 

6. There is Level 2 evidence supporting the administration of LMWH within the first 72 hours post ABI to reduce the risk of developing DVTs and PEs post injury.

 

7. There is Level 2 evidence that administering LMWH (enoxaparin) or heparin post ABI does not increase the risk of intracranial bleeding, compared to no treatment.

 

8. There is Level 4 evidence that the use of chemoprophylaxis 24 hours after stable head computed tomography scan decreases the rate of DVT formation post ABI.

 

9. There is Level 1b evidence that low-molecular-weight heparin combined with compression stockings is more effective than compression stockings alone for the prevention of venous thromboembolism following elective neurosurgery, and that the use of low-molecular-weight heparin in this setting does not cause excessive bleeding. 

 

10. There is Level 2 evidence that intermittent pneumatic compression devices alone are as effective as low molecular weight heparin for the prevention of DVT in patients with ABI.