How to proceed with patients who underwent a cranial operation for removal of meningeoma and postoperatively developed a pulmonary embolism (inspite of enoxaparin). Afterwards the initial therapy with Heparin and the patient developed heparin induced thrombocytopenia (Thrombos-20) and a later neurological deterioration occured because of bleeding in the op-situs(not requiring surgery)

Questions:

1. Relaiable articles on this topic?

2. What kind of anticoagulant is most suitable?

3. Treatment of heparin induced thrombocytopenia in those cases?

4. Have you had such cases in your departments?

Regards