Anticoagulation in Acute Neurological Disease.

dc.contributor.author

Sasannejad, Cina

dc.contributor.author

Sheth, Kevin N

dc.date.accessioned

2022-10-02T18:32:24Z

dc.date.available

2022-10-02T18:32:24Z

dc.date.issued

2021-10

dc.date.updated

2022-10-02T18:32:24Z

dc.description.abstract

While anticoagulation and its reversal have been of clinical relevance for decades, recent academic and technological advances have expanded the repertoire of its application in neurological disease. The advent of direct oral anticoagulants provides effective, mechanistically elegant, and relatively safer therapeutic options than warfarin for eligible patients at risk for neurological sequelae of prothrombotic states, particularly given the recent availability of corresponding reversal agents. In this review, we examine the provenance, indications, safety, and reversal tools for anticoagulant medications in the context of neurological disease, with specific attention to acute ischemic stroke, cerebral venous sinus thrombosis, and intracerebral hemorrhage. We will use specific clinical scenarios to illustrate the complex factors that must be considered in the use of anticoagulation, including intracranial pathology such as intracerebral hemorrhage, traumatic brain injury, or malignancy; metabolic complications such as chronic kidney disease; pregnancy; and advanced age.

dc.identifier.issn

0271-8235

dc.identifier.issn

1098-9021

dc.identifier.uri

https://hdl.handle.net/10161/26012

dc.language

eng

dc.publisher

Georg Thieme Verlag KG

dc.relation.ispartof

Seminars in neurology

dc.relation.isversionof

10.1055/s-0041-1733793

dc.subject

Humans

dc.subject

Brain Ischemia

dc.subject

Cerebral Hemorrhage

dc.subject

Warfarin

dc.subject

Anticoagulants

dc.subject

Stroke

dc.title

Anticoagulation in Acute Neurological Disease.

dc.type

Journal article

duke.contributor.orcid

Sasannejad, Cina|0000-0001-6617-567X

pubs.begin-page

530

pubs.end-page

540

pubs.issue

5

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Neurology

pubs.organisational-group

Neurology, Neurocritical Care

pubs.publication-status

Published

pubs.volume

41

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