Tricky question:you get a patient with brain hemorrhage at the same time this patient develops deep vein thrombosis (DVT),if you give him Heparin to treat DVT you will kill him because of the brain hemorrhage,if you donβt the thrombus might reach his lung. What would you do?
There are only two options for this patient: low molecular weight heparin or inferior vena cava filter. Low dose of LMWH should be started as early as possible. Although inferior vena cava filters are recommended according to literature but there is insufficient clinical evidence that they are effective.
First step is brain surgery,obviously this is the most urgent matter.then we place an ICV filter or (thrombectomy) to prevent pulmonary embolism.The Hemorrhage should be controlled first.
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