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Management of Patients on Anticoagulants and Antiplatelets in Neurosurgery

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Transfusion Practice in Clinical Neurosciences

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Abstract

For patients on antiplatelet and anticoagulation therapy undergoing neurosurgical intervention, appropriate management of administration and reversal is critical in protecting them from hemorrhagic injuries and minimizing risks of thromboembolic events. Although treatment for patients will differ based on individual co-morbidities, illness condition, and urgency/invasiveness of procedures, a generalized guideline can be established to serve as the backbone for anticoagulation management in neurosurgical patients. In this chapter, we seek to examine the pharmacologic properties of some commonly used anticoagulation/antiplatelet agents, determine the timing to stop and restart antithrombotic therapy based on type of procedure and risk of thrombosis in the patient, and evaluate the suitable reversal therapy given the urgency of procedure and anticoagulant dosing.

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Authors and Affiliations

  1. Department of Anesthesiology, SUNY Upstate Medical University, Syracuse, NY, USA

    Qi Yang, Reza Gorji & Fenghua Li

  2. Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, NY, USA

    Stephanie A. Zyck & Grahame Gould

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  1. Qi Yang
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  2. Stephanie A. Zyck
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  3. Grahame Gould
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  4. Reza Gorji
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  5. Fenghua Li
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Correspondence to Fenghua Li .

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Editors and Affiliations

  1. Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, Delhi, India

    Hemanshu Prabhakar

  2. Anesthesiology and Intensive Care, G B Pant Institute of Medical Education and Research, New Delhi, Delhi, India

    Monica S Tandon

  3. Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, Delhi, India

    Indu Kapoor

  4. Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, Delhi, India

    Charu Mahajan

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Yang, Q., Zyck, S.A., Gould, G., Gorji, R., Li, F. (2022). Management of Patients on Anticoagulants and Antiplatelets in Neurosurgery. In: Prabhakar, H., S Tandon, M., Kapoor, I., Mahajan, C. (eds) Transfusion Practice in Clinical Neurosciences. Springer, Singapore. https://doi.org/10.1007/978-981-19-0954-2_40

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  • DOI: https://doi.org/10.1007/978-981-19-0954-2_40

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