Compression Stockings Research Articles

Psychogenic Pseudosyncope: Real or Imaginary? Results from a Case-Control Study in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Patients.

Background and objectives: Orthostatic intolerance (OI) is a clinical condition in which symptoms worsen upon assuming and maintaining upright posture and are ameliorated by recumbency. OI has a high prevalence in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Exact numbers on syncopal spells especially if they are on a weekly or even daily basis are not described. Although not a frequent phenomenon, this symptomatology is of very high burden to the patient if present. To explore whether patients with very frequent (pre)syncope spells diagnosed elsewhere with conversion or psychogenic pseudosyncope (PPS) might have another explanation of their fainting spells than behavioral psychiatric disorders, we performed a case–control study comparing ME/CFS patients with and without PPS spells. Methods and results: We performed a case–control study in 30 ME/CFS patients diagnosed elsewhere with PPS and compared them with 30 control ME/CFS patients without syncopal spells. Cases were gender, age and ME/CFS disease duration matched. Each underwent a tilt test with extracranial Doppler measurements for cerebral blood flow (CBF). ME/CFS cases with PPS had a significant larger CBF reduction at end tilt than controls: 39 (6)% vs. 25 (4)%; (p < 0.0001). Cases had more severe disease compared with controls (chi-square p < 0.01 and had a p = 0.01) for more postural orthostatic tachycardia syndrome in cases compared with controls. PETCO2 end-tilt differed also, but the magnitude of difference was smaller than compared with the CBF reduction: there were no differences in heart rate and blood pressure at either end-tilt testing period. Compared with the test with the stockings off, the mean percentage reduction in cardiac output during the test with compression stockings on was lower, 25 (5) mmHg versus 29 (4) mmHg (p < 0.005). Conclusions: This study demonstrates that in ME/CFS patients suspected of having PPS, or conversion, CBF measurements end-tilt show a large decline compared with a control group of ME/CFS patients. Therefore, hypoperfusion offers an explanation of the orthostatic intolerance and syncopal spells in these patients, where it is clear that origin might not be behavioral or psychogenic, but have a clear somatic pathophysiologic background.

The Structure and Compression of Medical Compression Stockings.

This paper lays out standards of compression stockings and their classification into classes. The analysis of knitted fabric structure parameters, elongation and compression of moderate- and high-compression stockings was conducted. Stocking compression on specific parts of the stocking leg was measured on three sizes of a wooden leg model. For moderate-compression stockings, compression above the ankle was 32 hPa. For high-compression stockings, compression above the ankle was 60 hPa. Both groups of the analyzed compression stockings were made on modern one-cylinder hosiery automats. The legs of the stockings were made in single inlaid jersey 1 + 1. Both yarns were elastane covered. The finer yarn formed loops and its knitting into a course was significantly larger than in the other yarn, which was much coarser and does not form loops but “lay the weft in a bent way”. The smallest elongation of knitted fabric was above the ankle, where the highest compression was achieved, while the largest elongation was under the crotch, where the stocking leg exerted the smallest compression on the surface. The leg of the compression stocking acted as a casing that imposed compression on the leg and often reinforced it to be able to sustain compression loads.

Positive perception and efficacy of compression stockings for prevention of lower limb edema in pregnant women.

BackgroundPregnancy is characterized by physiological changes that can contribute to development of varicose veins, venous insufficiency, and leg edema.ObjectivesTo evaluate the effect of compression stocking on lower limb edema in pregnant women and their perceptions of wearing them.MethodsThis was a randomized, controlled, prospective, parallel, blinded clinical trial conducted with 60 pregnant women randomly distributed into two groups: an intervention group (n = 30) wearing compression stockings and a control group (n = 30). Standardized ankle and calf measurements were taken of all 120 lower limbs using a tape measure. At the end of the study, a questionnaire was administered to identify perceived difficulties and advantages related to wearing compression stockings.ResultsPregnant women in the intervention group had a significantly smaller increase (p < 0.05) in calf and ankle diameters compared to those in the control group. The mean differences from the beginning to the end of gestation in the diameters of the right calf, left calf, right ankle, and left ankle respectively were 0.30 cm, 0.30 cm, 0.15, cm and 0.15 cm in the intervention group and 1.95 cm, 1.95 cm, 1.73 cm, and 1.87 cm in the control group. Most of the pregnant women had no difficulty wearing the compression stockings and all reported that they felt a difference in leg symptoms and would wear stockings again.ConclusionsCompression stockings were effective for preventing lower limb edema in pregnant women, who had a positive perception of wearing them.

EFFICIENCY OF DEEP VENOUS THROMBOSIS PREVENTION IN PROXIMAL FEMUR FRACTURES.

To determine the efficiency of the deep venous thrombosis (DVT) prophylaxis protocol in postoperative patients due to proximal femoral fractures and to assess any statistical difference between the types of fractures. A retrospective observational study based on the analysis of patients' medical records who underwent to a surgical intervention due to proximal femoral fractures in 2017 and 2021 at Hospital IFOR - Rede D'Or São Luiz. These patients were selected according to previously determined inclusion and exclusion criteria. A total of 99 patients were included divided by sex, age, laterality, length of stay, and death. According to the institutional protocol, was used chemoprophylaxis with low-molecular-weight heparin, associated use of pneumatic compression with compression stockings, and early gait. The DVT diagnosis was determined by clinical evaluation and imaging tests such as venous Doppler ultrasonography and laboratory tests. The protocol was effective in our study. Only one (1.01%) patient developed DVT. Due to the lack of samples, we could not achieve our secondary objective. The institutional protocol is efficient for DVT prophylaxis and essential in these cases. Level of Evidence II, Prognostic Study.

Pure autonomic failure-A localized alpha synucleinopathy with a potential for conversion to more extensive alpha synucleinopathies

Pure autonomic failure (PAF) is an alpha synucleinopathy with predominant involvement of the autonomic ganglia and peripheral nerves. The hallmark clinical feature is orthostatic hypotension. However, genitourinary, sudomotor, and cardiac involvement is also common. Many patients also develop supine hypertension. Almost a quarter of patients can phenoconvert or evolve into Parkinson's disease, multiple system atrophy, and Lewy body dementia in the future. Early severe bladder involvement, higher supine noradrenaline level, early motor involvement, and dream enactment behavior increase the risk of phenoconversion. The diagnosis is confirmed via autonomic function testing and serum noradrenaline measurement. The treatment is mainly supportive. The non-pharmacological treatment includes adequate fluid, dietary salt, compression stockings, and abdominal binders. The drug therapies to improve blood pressure include midodrine, fludrocortisone, pyridostigmine, and droxidopa. The diagnostic criteria need to be updated to incorporate the recent understandings. The treatment of orthostatic hypotension and supine hypertension is mainly based on case series and anecdotal reports. Randomized control trials are needed to ascertain the best treatment strategies for PAF.

Epidemiological, Clinical and Therapeutic Patterns of Venous Thromboembolic Disease in Cancer Patients Followed up in Two Reference Hospitals in Cameroon

Background: Cancer increases the incidence of venous thromboembolic disease (VTE), which represents a significant cause of morbidity, mortality, and economic burden in cancer patients. Objective: We aimed to describe the epidemiologic, clinical, and therapeutic pattern of VTE in cancer patients followed-up in two reference hospitals in Cameroon over the past ten years. Methods: This was a cross-sectional retrospective study conducted in the oncology department of the General hospitals of Yaoundé and Douala. We included the medical records of all patients aged 18 years and above who had active cancer with a confirmed diagnosis of VTE from 2010 to 2021. Results: We analysed 408 patients’ medical records. The prevalence of VTE was 7.6%. All those having VTE had solid tumours. There were twenty (64.5%) cases of deep venous thrombosis, five (16.1%) cases of pulmonary embolism, and three (9.7%) cases of both. Poor performance status and chemotherapy were independently associated with the development of VTE. Most of the patients were treated with compression stockings and low molecular weight heparin. Conclusion: VTE prevalence is high among cancer patients in Cameroon. It is most frequent in solid tumours originating from the genitourinary system, the lung, the pancreas, and the brain.

Analysis of muscle condition by calf raises exercise while wearing compression socks

Analysis of muscle condition by calf raises exercise while wearing compression socks

Prevention of Deep Vein Thrombosis among Patients Having Undergone Neurosurgery: A Systematic Review

Deep vein thrombosis (DVT) and pulmonary thromboembolism are high in the setting of neurosurgery causing significant mortality and morbidity. Incidence of venous thromboem- bolism among neurosurgery patients is very high (approximately 23%) in the absence of prophylaxis. There is no consensus among surgeons regarding. A systematic review following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines for design, conduct and reporting was conducted to find out the evidences for DVT prophylaxis among neurosurgery patients and to develop an evidence-based protocol for prevention of DVT. Eligibility criteria was to include studies done among adult patients who had undergone craniotomies or spinal cord. Data were summarized in a pre-defined data extraction form. Summarized information on study characteristics such as design and year, author information, sample size, prophylactic method used, outcome, side effects, investigations done and the timing of prophylactic method used. Risk of bias for randomised controlled trials (RCT) were assessed using predefined Cochrane risk of bias tool. Observational studies were assessed for risk of random and systematic bias. All the studies except one are having high risk of bias. The total participants of included studies were 2811. The incidence of symptomatic DVT ranged from 0.01-0.6 percent. Asymptomatic DVT incidence ranged from 4-29.4 percent. The prophylactic methods used were pneumatic compression devices, low molecular weight heparin (LMWH), nadroparin, venacaval filter, elastic compression stockings and physiotherapy. There was no significant difference between the chemo prophylactic and mechanical prophylactic group. Chemoprophylaxis was used post-operatively after 12 hours to 5-6 days. The pneumatic compression device and elastic crepe bandage were used peri-operatively. The incidence of post-operative bleeding and hematoma with the use of LMWH and nadroparin was 0.4 to 1.8 percent, which is within the limits of usual post-operative risk of bleeding. The use of compression device was associated with minor skin irritations. These findings suggest that pharmacological and mechanical prophylaxis can be combined to prevent DVT among neurosurgery patients without increased bleeding risk or discomfort.

Lipoedema: detailed left atrial volumetric and strain analysis by three-dimensional speckle-tracking echocardiography from the MAGYAR-Path Study.

IntroductionLipoedema is a chronic feminine disease with disproportional painful fat deposition of the lower body half and occassional arm affection.AimThe objective of the present study was to assess LA volumetric and functional properties by three-dimensional speckle-tracking echocardiography (3DSTE) in patients with lipoedema and to compare their results to age- and gender-matched healthy controls. It was also aimed to examine whether one-hour use of medical compression stockings (MCS) has any effect on LA volumes and functional properties.Material and methodsThe study comprised 25 female patients with stage 2 lipoedema (mean age: 42.5 ±12.2 years). Their results were compared to those of the control group consisting of 54 age- and gender-matched healthy female subjects (mean age: 42.7 ±10.6 years) without classic risk factors.ResultsIncreased LA volumes could be measured in lipoedema patients as compared to controls regardless of the phase of the cardiac cycle it was measured in, and the LA volumes showed further increase after 1-hour use of MCS. Similarly, LA total and active stroke volumes and LA passive emptying fraction were increased in lipoedema patients, and these parameters were further increased in systole and early-diastole. Peak global radial and 3D strains were increased in lipoedema patients. Peak global longitudinal strain increased in lipoedema patients after one-hour use of MCS compared to data measured at rest.ConclusionsLipoedema is associated with increased LA volumes and changes in LA functional properties. The use of MCS further increases some of the LA volumetric parameters.

Platelet-rich-fibrin for venous leg ulcer therapy

Background: Venous leg ulcer (VLU) is a chronic condition in the chronic venous insufficiency clinical spectrum. It&rsquo;s becoming a burden because of its chronicity, slower wound healing, accumulated high cost, and treatment is a challenging task. Platelet-rich-fibrin (PRF) is one of the newer modalities available for treating VLU. Previous studies have shown successful results by using PRF in leg ulcers. We reported a case of venous leg ulcer treated with PRF. Case Illustration: A 47-year-old male came with an ulcer on the lower left l eg for one year. The ulcer was preceded with a reddish, tender nodule with a pustule, which then ruptured, resulting in a wound. There was intermittent pain at the lesion with a limb cramp. The patient had used compression stocking, leg elevation, normal saline compress, and topical antibiotics with no improvement. PRF was given for 12 weeks along with compression stocking and leg elevation, which resulted in a clinically improved lesion. Discussion: Wound therapy has greatly improved over the past decades. The interest in the wound care field has led to advancements in biological products as one of its modalities. Platelet-rich-fibrin is an autologous platelet and leucocyte-rich fibrin material which forms an organiz e d network where the platelets and leucocytes are concentrated, leading to the sustained release of various growth factors, and promoting wound healing. Previous studies have shown PRF to be effective and low-cost for VLU. Conclusion: The use of PFR on VLU is an alternative method, low cost, and simple technique with good healing potential. &nbsp; Keywords : chronic ulcers, platelet-rich-fibrin, venous ulcers &nbsp;

COVID-19, long flights, and deep vein thrombosis: What we know so far.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 [COVID-19]) pandemic has presently stunted the growth of the airline industry. Despite the setbacks, pre-COVID-19 passenger numbers are forecasted to return by as early as 2024. As the industry recovers, the number of long-distance flights will surely continue to increase like it did before the pandemic. The incidence of venous thromboembolism (VTE) following air travel is also likely to increase. Although not common, the unique environment of air travel exposes individuals with particular health conditions to an elevated risk of acquiring VTEs. Numerous factors increasing the risk of developing VTE related to air travel have been identified, including inherited and acquired flight-related aspects. Non-pharmacological approaches to reduce air travel-related VTEs involve simple foot movements, compression socks and stockings, intermittent pneumatic compression devices, a novel modified airline seat, and foot exercisers. Pharmacological methods include heparins and direct oral anticoagulants. More than 30 reliable articles were evaluated to present the current knowledge regarding air travel-related VTEs, their risk factors, and prophylactic methods. Issues in research methodologies found in the literature were identified and discussed. Further research involving international collaboration projects is recommended. The authors’ perspectives regarding long flights in previously infected COVID-19 individuals are also included.

Risk of deep vein thrombosis and pulmonary embolism after gynecological day surgery

ObjectiveTo investigate the risk of venous thromboembolism (VTE) in Danish women operated within a day surgery setting and to evaluate whether the current use of thromboprophylaxis without using graduated elastic compression stockings (GCS) is an appropriate treatment to prevent VTE. Study designA retrospective cohort study including women who underwent laparoscopic hysterectomy or vaginal prolapse operation for benign disease from January 2014 to December 2017 at the Gynecology Day Surgery Unit, Regional Hospital of Randers, Denmark. The primary outcome was VTE diagnosed within three months postoperatively. Only one dose of pharmacological thromboprophylaxis (PTP) was given to women stratified at high risk of VTE. None of the women used GCS. ResultsA total of 671 women were included. Vaginal prolapse operations were performed on 626 women, and laparoscopic hysterectomy on 45 women. PTP was used for only 220 (32.8%) of these women. A total of 346 (51.5%) women were stratified as at high risk of VTE according to the national recommendations. Only 218 (63%) of these women received PTP, while 128 women (37%) did not receive PTP. The incidence of VTE within three months postoperatively was 0%. Only 13 (1.9%) of the women were readmitted within 14 days postoperatively due to hemorrhaging or hematoma; six out of these 13 women (46%) received PTP postoperatively. Re-operation was performed in seven (1%) women due to hemorrhaging, and three out of the seven (42.9%) had PTP postoperatively. ConclusionThe risk of VTE in Danish women operated within a day surgery setting is probably very low since we found no cases of VTE in our setup. The beneficial effect of routine use of GCS and one dose of PTP postoperatively given to all women who had undergone MIS in a day surgery setting are questioned. One dose of PTP postoperatively without GCS can be considered to only women stratified as high-risk of VTE until there is more evidence whether these women actually need thromboprophylaxis postoperatively at all. PrecisThe incidence of VTE in women undergoing laparoscopic hysterectomy or vaginal prolapse operation in a day surgery setting without using graduated elastic compression stockings is very low.

Screening Risiko Terjadinya Deep Vein Trhombosis

This study aimed to examine several studies on early screening and prevention of the risk of developing Deep Vein Thrombosis (DVT). The method used in this literature review consists of 4 stages: (1) identification of the search for journal articles; (2) identification of literary works based on title, abstract, and purpose; (3) inclusion criteria; (4) complete and specific texts are available according to the purpose of the review. The process of searching for journal articles using Google Scholar, ScienceDirect, DOAJ, Scopus, ProQuest, Ebsco and Pubmed. The results showed that most early DVT screenings used ultrasound as a non-pharmacological DVT detection and prevention tool, the most frequently used was compression stockings. In conclusion, compression stockings are more effective in preventing DVT.&#x0D; Keywords: Early Detection, DVT, Bed Rest

Development of Cotton-Based Compression Stockings for Class II Compression Requirements

Development of Cotton-Based Compression Stockings for Class II Compression Requirements

Compression Stockings Improve Cardiac Output and Cerebral Blood Flow during Tilt Testing in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Patients: A Randomized Crossover Trial.

Background and Objectives: Orthostatic intolerance (OI) is a clinical condition in which symptoms worsen upon assuming and maintaining upright posture and are ameliorated by recumbency. OI has a high prevalence in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Limited data are available to guide the treatment of OI in ME/CFS patients. We and others have previously described patient-reported subjective improvement in symptoms using compression stockings. We hypothesized that these subjective reports would be accompanied by objective hemodynamic improvements. Materials and Methods: We performed a randomized crossover trial in 16 ME/CFS patients. Each underwent two 15-min head-up tilt table tests, one with and one without wearing knee-high compression stockings that provided 20–25 mm Hg compression. The order of the tests was randomized. We measured heart rate and blood pressure as well as cardiac output and cerebral blood flow (CBF) using extracranial Doppler of the internal carotid and vertebral arteries. Results: There were no differences in supine measurements between the 2 baseline measurements. There were no differences in heart rate and blood pressure at either end-tilt testing period. Compared to the test with the stockings off, the mean percentage reduction in cardiac output during the test with compression stockings on was lower, 15 (4)% versus 27 (6)% (p < 0.0001), as was the mean percentage CBF reduction, 14 (4)% versus 25 (5)% (p < 0.0001). Conclusion: In ME/CFS patients with orthostatic intolerance symptoms, cardiac output and CBF are significantly reduced during a tilt test. These abnormalities were present without demonstrable heart rate and blood pressure changes and were ameliorated by the use of compression stockings.

Outcomes Comparison between Low Molecular-Weight Heparin with Mechanical Prophylaxis versus Mechanical Prophylaxis Alone for Perioperative Venous Thromboembolism Prevention in Abdominopelvic Surgery: A Randomized Controlled Trial

Background: Pharmaco-mechanical prophylaxis has been recommended for venous thromboembolism (VTE) prevention in surgical patients. The rate of receiving pharmacological prophylaxis was low due to the bleeding concern. The mechanical prophylaxis; either intermittent pneumatic compression (IPC) or graduated compressive stocking (GCS), becomes a preferred method, although its VTE incidence was higher than pharmaco-mechanical prophylaxis. The combination of IPC and GCS had a lower risk of DVT than GCS alone. We examined the efficacy of combining mechanical prophylactic methods; IPC and GCS, in VTE prophylaxis. Objective: The present study aimed to compare the pharmaco-mechanical method with combining mechanical method in VTE prophylactic effectiveness and adverse events for elective abdominopelvic surgery. Materials and Methods: A randomized controlled trial was conducted in elective abdominopelvic surgical patients. The control group received low molecular weight heparin, IPC, and GCS, whereas the study group received IPC and GCS. Results: We enrolled 76 elective abdominopelvic surgical patients, 39 patients in the control group, and 37 patients in the study group. Surgery for cancer was accounted for 64 (84.2%) and Caprini score was 8.4 (&plusmn;1.95). The incidence of perioperative VTE was 5 (6.58%). All VTE cases were asymptomatic DVT. In the present study group, 1 (2.7%) of proximal DVT and 3 (8.1%) of calf vein DVT occurred. Only 1 (2.6%) of proximal DVT occurred in the control group. The incidence of VTE tended to be higher in the present study group than in the control group; 4 (10.8%) vs. 1 (2.6%); RR 4.22, 95% CI 0.49 to 36.00, p-value=0.194). The adverse event such as symptomatic pulmonary embolism (PE), bleeding complication, and readmission rate was not found. Conclusion: The effectiveness of IPC combined with GCS was not superior to pharmaco-mechanical thromboprophylaxis for VTE prevention in high-risk surgical patients. Keywords: VTE cancer surgery, DVT prophylaxis, VTE prophylaxis, DVT, PE, Deep vein thrombosis, Pulmonary embolism, mechanical thromboprophylaxis, Intermittent pneumatic compression (IPC), Graduated compression stockings (GCS)

2021 Canadian Surgery Forum: Virtual, online Sept. 21-24, 2021.

# 01. Design and validation of a unique endoscopy simulator using a commercial video game {#article-title-2} Procedural simulation has been shown to enhance early endoscopy training. In this proof of concept study, we aimed to show that a first-person shooter (FPS) video game with a novel in-house

Third-Degree Burn on the Neuropathic Lower Extremity in a Patient With Diabetes While Wearing a Copper–Containing Compression Sock: A Case Report

Many patients who have diabetes and peripheral neuropathy wear compression socks, which are widely available and may be purchased with a copper component. There is also a well-documented history of patients with neuropathy developing thermal burns from heat sources. Patients with diabetes are at an increased risk of complications when they sustain burns. To describe a patient with diabetes and neuropathy who developed third-degree burns while wearing a copper-containing compression sock. A 68-year-old man with type 2 diabetes and peripheral neuropathy wore a copper-containing compression sock while sitting in the sun for several hours. Afterward, he noted severe blistering and was ultimately diagnosed with several areas of second- and third-degree burns. Wound treatment included sharp debridement, dressing management, and tubular compression. All wounds were healing well when the patient was lost to follow-up. This case report illustrates the risk of burn injury when wearing compression socks infused with copper in a situation in which the sock could absorb heat, especially in persons with neuropathy. This report and previous studies showing the increased risk of burn injury complications in persons with diabetes underscore the importance of burn prevention education in this population. Future research to examine the thermal conductivity of metal-containing clothing is recommended.

Effects of Compression Socks on Muscle Recovery after Induced Fatigue

The purpose of this study was to determine the influence of the compression on muscle recovery after sports. Four kinds of gradient pressure socks were randomly ordered into 24 groups. Each subject needed to complete six experiments of all. The experiment was divided into two parts including a fatigue induced experiment and an intermittent fatigue induced experiment. The vertical jump height, blood oxygen saturation, local hemoglobin, blood flow, and Visual Analogue Score (VAS) were tested in each experiment. It was found that high pressure level has a significant effect on the vertical height after intermittent induced fatigue; however, the analysis showed no difference among sock pressure levels on blood oxygen saturation, local hemoglobin, blood flow, or VAS subjective feeling evaluation. The effect of compression socks was better than that of non-pressure socks. If the exercise intensity is strong, high-pressure socks can make contributions on recovery. If the exercise intensity is low, low-pressure socks contribute to greater comfort. This study concluded that different exercise intensities required different sock pressures to promote the muscle recovery after sports.

Venous thromboembolism prophylaxis and related outcomes in patients with traumatic brain injury and prolonged intensive care unit stay

Objective: Traumatic brain injury (TBI) patients with prolonged intensive care unit (ICU) stay are at risk of secondary intracranial haemorrhage (ICH) and venous thromboembolism (VTE). We aimed to study VTE prophylaxis, secondary ICH, and VTE prevalence and outcomes in this population. Design: Retrospective observational study. Setting: Level 1 trauma centre ICU. Patients: One hundred TBI patients receiving prolonged ICU treatment (≥ 7 days). Interventions: We collected data from medical records, pathology and radiology systems, and hospital and ICU admission databases. We analysed patient characteristics, interventions, episodes and types of secondary ICH and VTE, and timing and dosage of VTE prophylaxis. Results: Data from the 100 patients in our study showed that early use of compression stockings and pneumatic calf compression was common (75% and 91% in the first 3 days, respectively). VTE chemoprophylaxis, however, was only used in 14% of patients by Day 3 and > 50% by Day 10. We observed VTE in 12 patients (10 as pulmonary embolism), essentially all after Day 6. Radiologically confirmed secondary ICH occurred in 43% of patients despite normal coagulation. However, 72% of ICH events (42/58) were radiologically mild, and the median time of onset of ICH was Day 1, when only 3% of patients were on chemical prophylaxis. Moreover, 82% of secondary ICH events (48/58) occurred in the first 3 days, with no severe ICH thereafter. Conclusions: In TBI patients receiving prolonged ICU treatment, early chemical VTE prophylaxis was uncommon. Early secondary ICH was common and mostly radiologically mild, whereas later secondary ICH was essentially absent. In contrast, early VTE was essentially absent, whereas later VTE was relatively common. Earlier chemical VTE prophylaxis and/or ultrasound screening in this population appears logical.