====== Anticoagulation considerations in neurosurgery ======

Most of these issues have not been studied in a rigorous, prospective fashion. Yet, these questions frequently arise. The following is to be considered a framework of [[guideline]]s and is not to be construed as a standard of care. 

Choice of oral anticoagulant: compared to [[vitamin K antagonist]]s (VKAs) (e.g. [[warfarin]]), the novel [[oral anticoagulant]]s (NOACs) [[dabigatran]], [[rivaroxaban]] & [[edoxaban]] are at least as effective in preventing [[ischemic stroke]] and systemic [[embolization]] in patient with [[atrial fibrillation]]. And compared to warfarin, NOACs reduce ICH by about 50%, have a more rapid onset of action, a shorter half-life, more predictable pharmacokinetics, fewer drug-drug interactions, and do not require routine monitoring.