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Emergency reversal of anticoagulation and antiplatelet therapies in neurosurgical patients - A review

Joseph E. Beshay, M.D., Howard Morgan, M.D., M.A., M.S., Christopher Madden, M.D., Wengui Yu, M.D., and Ravindra Sarode, M.D.

J Neurosurgery vol 112:2, 2010, p 307-318.

Intracranial hemorrhage (ICH) is a common problem encountered by neurosurgeons. Patient outcomes are influenced by hematoma size, growth, location, and the timing of evacuation, when indicated. Patients may have abnormal coagulation due to pharmacological anticoagulation or coagulopathy due to underlying systemic disease or blood transfusions. Strategies to reestablish the integrity of the clotting cascade and platelet function assume a familiarity with these processes. As patients are increasingly treated with anticoagulants and antiplatelet agents, it is essential that the physicians who care for patients with ICH understand these pathways and recognize how they can be manipulated to restore hemostasis.

Address correspondence to: Joseph E. Beshay, M.D., University of Texas Southwestern, 5323 Harry Hines Boulevard, Dallas, Texas 75390. email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

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