Concluded Case

Anticoagulant in SAH post op patient

65 year male known c/o AF(rate control) on tab Acitrom 2mg/CCB/ from last 2 years..noted with sudden onset confusion..no h/o fall,trauma..CT s/o Subdural hematoma with mid line shift ( Spontaneous SDH)..craniotomy done..pt recovered.. repeat CT WNL.. now how can we reinstated Oral anticoagulant? any criteria?

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Concluded answer
Can be started after 4 days to max 7 days later, if no bleeding focus
All Answers
Reinstitution of anticoagulant vary considerably. High risk patient with in one week.Check with the cardiologist to see he is at high risk or not. RAPID AF HIGH RISK.A thrombus in the LA high risk. If not high risk 1 to 4 weeks ideal. THERE ARE OCCASSIONS STARTING AFTER 4CWEEKS ALSO. There is considerable variation in current practice.
Thank you doctor
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Can be started after 4 days to max 7 days later, if no bleeding focus
Thank a lot sir..
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Very common to see..Recently operated one sdh on anticoagulation.. stop anticoagulant, give ffp.. do surgery.. good outcome..my patient gcs 7, both pupil dilated before surgey...went home walking
can be start after 5 - 7 days check Coagulation profile and Cardiologist opinion also
Usually started after 5-7 days if no excess bleeding risk after brain surgery
PK, USUALLY it's started from 3-4 day onwards.
Thanks Abhijeet..

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