Walking the Razor's Edge—Anticoagulation-induced Intracerebral Hemorrhage and the Perplexity in Choosing between International Normalized Ratio and Point-of-care Tests as a Reliable, Definitive, Coagulation Testing Parameter in Neurosurgical Management
Joanna S Rodrigues, Vaishali Kulkarni, Ankit Gupta
International normalized ratio, Neurosurgery, Thromboelastography (TEG), Warfarin
Citation Information :
Rodrigues JS, Kulkarni V, Gupta A. Walking the Razor's Edge—Anticoagulation-induced Intracerebral Hemorrhage and the Perplexity in Choosing between International Normalized Ratio and Point-of-care Tests as a Reliable, Definitive, Coagulation Testing Parameter in Neurosurgical Management. Res Inno in Anesth 2020; 5 (2):43-45.
Urgent reversal of anticoagulation in patients on warfarin therapy for neurosurgical procedures can be quite tricky as well as risky. Anticoagulation reversal using blood products has its own challenges and their administration must be guided with effective, investigative tools such as international normalized ratio (INR) and point-of-care coagulation tests. However, the superiority of either in neurosurgical procedures has not been established. Hence, a careful risk calculation must be done considering the overall clinical picture of the patient as well. We present a case report in which we faced such a dilemma.
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