🩸 Anticoagulation [Neurosurgery Wiki]

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====== 🩸 Anticoagulation ======

**Anticoagulation** refers to the use of medications that **inhibit blood clot formation**, reducing the risk of thromboembolic events (e.g., stroke, pulmonary embolism), but increasing the risk of **bleeding**, especially in the **central nervous system**.

===== 💊 Main Classes of Anticoagulants =====
  * **Vitamin K antagonists**:
    * Example: Warfarin
    * Requires INR monitoring
  * **Direct oral anticoagulants (DOACs)**:
    * Direct thrombin inhibitor: **Dabigatran**
    * Factor Xa inhibitors: **Rivaroxaban, Apixaban, Edoxaban**
  * **Heparins**:
    * Unfractionated heparin (UFH) – IV, reversible with protamine
    * Low molecular weight heparin (LMWH) – e.g., enoxaparin

===== ⚠️ Risks in Neurosurgery =====
  * ↑ Risk of **intracranial hemorrhage** with trauma or surgery
  * Delayed bleeding despite initial normal CT
  * Potential need for **emergency reversal agents**
  * Influence on **surgical timing** and **postoperative care**

===== Anticoagulation Management =====

[[Anticoagulation Management]]