Common Conditions Requiring Long-Term Anticoagulation in Neurosurgical Patients

Neurosurg Clin N Am. 2018 Oct;29(4):529-535. doi: 10.1016/j.nec.2018.06.009.

Abstract

Long-term anticoagulant therapy prevents thrombosis. Management of neurosurgical patients with conditions such as atrial fibrillation, mechanical heart valves, and other prothrombotic states necessitates application of a strategy to mitigate hemorrhagic complications of anticoagulation. Development of direct oral anticoagulants, which include the direct thrombin and factor X inhibitors, yields new considerations to be had, in particular, the introduction of reversal agents. This article reviews the more common chronic clinical entities that require the use of prolonged anticoagulant therapy with special consideration for neurosurgical patients. It also includes a discussion of established treatment strategies across available treatment options.

Keywords: Anticoagulation; Antithrombotic; Atrial fibrillation; Bioprosthetic valve; Mechanical heart valve; Prothrombotic; Thrombogenic; Thrombophilia.

Publication types

  • Review

MeSH terms

  • Anticoagulants / therapeutic use*
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / drug therapy*
  • Cerebrovascular Disorders / complications
  • Cerebrovascular Disorders / drug therapy*
  • Humans
  • Neurosurgical Procedures / adverse effects
  • Neurosurgical Procedures / methods*
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome

Substances

  • Anticoagulants