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Evaluation and Management of Untoward Intraoperative Bleeding

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Anticoagulation and Hemostasis in Neurosurgery

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Abstract

Abnormal or excessive bleeding during neurosurgical procedures could have devastating consequences and requires diligent, expedient workup and management coordinated by the neurosurgeon and anesthesiologist working together. Multiple modalities now exist in order to evaluate the patient’s ability to clot blood, and point of care testing can isolate the problem to platelet dysfunction, coagulation cascade abnormalities, or some other global phenomenon. Hemostatic agents and alterations in hemodynamics may help to reduce this blood loss and allow the surgeon to identify and control the source of bleeding. Blood salvage techniques may be utilized to reduce the amount of allogenic blood products received, and specific diagnostic techniques may also help facilitate hemostasis and direct the administration of medication to help improve platelet function and reduce or inhibit thrombolysis. A systematic and coordinated effort can decrease overall blood loss and minimize associated morbidity.

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Authors and Affiliations

  1. Department of Neurological Surgery, Loyola University Medical Center, 2160 S. 1st Ave, Maywood, IL, 60153, USA

    Michael P. Wemhoff M.D.

  2. Department of Anesthesiology, Loyola University Medical Center, 2160 S. 1st Ave, Maywood, IL, 60153, USA

    W. Scott Jellish M.D., Ph.D.

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  1. Michael P. Wemhoff M.D.
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  2. W. Scott Jellish M.D., Ph.D.
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Correspondence to Michael P. Wemhoff M.D. .

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Editors and Affiliations

  1. Stritch School of Medicine, Loyola University, Maywood, Illinois, USA

    Christopher M. Loftus

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Wemhoff, M.P., Jellish, W.S. (2016). Evaluation and Management of Untoward Intraoperative Bleeding. In: Loftus, C. (eds) Anticoagulation and Hemostasis in Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-27327-3_12

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  • DOI: https://doi.org/10.1007/978-3-319-27327-3_12

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  • Publisher Name: Springer, Cham

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