Abstract: Objective To study the silent pulmonary thromboembolism (SPE) and improve the management of diagnosis and treatment to the patients. Methods To analyze the clinical data of 2 cases who were diagnosed as SPE. Based on screening of D-dimer, ultrasound imaging and CTPA, the patients were diagnosed and treated initialy with low-dose heparin or low-molecular-weight heparin and then with warfarin. 1of the 2 cases had implanted permanent inferior vena cava filters before Anticoagulation. Results One of the result of D-dimer is 573μg/L(156μg/L after treatment)，the other is 246μg/L(50μg/L after treatment). The ultrasound imaging showed the low extremities vein thrombosis and the CTPA confirmed the pulmonary thromboembolism. Both of them discharged after re-examinations with CTPA which showed the improvement of pulmonary thromboembolism. Conclusion The neurosurgeons should pay much attention on the high risks of SPE and screen such patients ealier. The critical thing is to make a program to prevent and treat SPE peri-operatively.

Key words: silent pulmonary thromboembolism, deep venous thrombosis, neurosurgery, operation, complication