PREvention of VENous Thromboembolism In Hemorrhagic Stroke Patients
PREvention of VENous Thromboembolism In Hemorrhagic Stroke Patients
Patients with cerebral hemorrhage (ICH) have a high risk of venous thromboembolism.
 Intermittent pneumatic compression combined with elastic stockings have been shown to be
 superior to elastic stockings alone in reducing the rate of asymptomatic deep vein thrombosis
 after ICH in a randomized trial (4.7% vs. 15.9%). Graduated compression stockings alone are
 ineffective in preventing deep vein thrombosis in patients with ischemic or hemorrhagic
 stroke. Less clear is the role of anticoagulation in the prevention of venous thromboembolism
 in patients with ICH because the use of anticoagulants may cause an enlargement of the
 hematoma. In a multicenter, randomized trial, the investigators will assess the efficacy and
 safety of enoxaparin in the prevention of venous thromboembolism in patients with spontaneous
 intracerebral hemorrhage. Enoxaparin (40 mg once daily) or standard therapy (graduated
 compression stockings and/or intermittent pneumatic compression and/or early mobilization)
 will be given subcutaneously for not less than 10 days beginning after 72 hours from stroke
 onset.
Inclusion Criteria:

 -  Intracranial spontaneous hemorrhage on brain CT scan

 -  Intracranial hemorrhage during treatment with oral anticoagulants

 -  Bedridden patients (item 6 of NIHSS: motor leg points 3 or 4 or severe ataxia for
 cerebellar hemorrhage).

 Exclusion Criteria:

 -  cerebral hemorrhage due to intracranial vascular malformation

 -  rebleeding on CT scan after 72 hours from stroke (before randomization)