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Hematological Management of Neurocritical Care Patients

  • Aleksey Tadevosyan
  • Jovany Cruz Navarro
  • Izad-Yar Rasheed
  • Monisha A. KumarEmail author
Chapter

Abstract

Intracranial hemorrhage is a devastating complication of antithrombotic use, systemic coagulopathies, or bleeding diatheses. Physiological derangements, such as autoimmune dysfunction, acute infection, organ dysfunction, systemic disease, and therapeutic medications, often lead to dysfunctional hemostasis in the intensive care unit (ICU). These derangements pose complex management dilemmas, especially when it results in intracranial hemorrhage, as coagulopathy worsens neurologic prognosis and functional outcome. Increased utilization of antithrombotic medications mandates a thorough understanding of these treatments as well as their reversal agents, as prompt reversal may limit volume of hemorrhage. This chapter will focus on acquired coagulopathies that are associated with increased bleeding risk that result in various forms of intracranial hemorrhage.

Keywords

Antithrombotic-related intracranial hemorrhage Antithrombotic reversal Anticoagulant resumption Intracranial bleeding Brain bleeds Reversal of anticoagulation 

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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Aleksey Tadevosyan
    • 1
  • Jovany Cruz Navarro
    • 2
  • Izad-Yar Rasheed
    • 1
  • Monisha A. Kumar
    • 1
    Email author
  1. 1.Department of NeurologyUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Department of Anesthesiology and NeurosurgeryBaylor College of MedicineHoustonUSA

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