University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository




Elanagan Nagarajan, MD; Olivia Morgan, Pharm D


ABSTRACT Aim: The primary purpose of this study is to address and discuss challenges involved with antithrombotic-related intracranial hemorrhage (ICH) and its associated risk in resumption. Method: An Ovid MEDLINE search was conducted, and the search strategy was based on the combination of the following keywords: intracranial hemorrhage, anticoagulant, atrial fibrillation, heart valve prosthesis, resumption of the antithrombotic agent. Forty – three pertinent articles were retrieved and served as the basis for this clinical review. Discussion: Although there are no clear guidelines for when to resume anticoagulation after ICH, existing evidence supports resuming anticoagulation after ICH. There is a significant reduction in the recurrent thromboembolic events after being on anticoagulation followed by an ICH. The risk of recurrent hemorrhage is similar to the patients who are not anticoagulated following ICH. The clinician's perceived individual patient risk profile primarily drives the decision to resume anticoagulation. Conclusion: Resuming anticoagulation in patients with ICH history is relatively safe and reduces recurrent thromboembolic events. The timing of resuming depends on the individual risk profile


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