====== 🩸 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]]