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The Dilemma of Reinstituting Anticoagulation for Patients With Cardioembolic Sources and Intracranial Hemorrhage
How Wide Is the Strait Between Skylla and Karybdis?
Arch Neurol. 2000;57:1682-1684.
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And it happened that Ulysses after successfully fighting the sirens' sweet seductive songs entered the strait between Skylla, a deadly current, and Karybdis, a terrifying creature living on a mist-clouded rock just opposite of Skylla, both being a deadly threat to the ancient mariners.—Homer, Tales of the Brave Ulysses
THE PROBLEM
In this issue of the ARCHIVES, Phan and colleagues1 report an extension (hereinafter referred to as "the Mayo series") of a previously published series2 on patients with strict indication for oral anticoagulants who had intracranial bleeding. With a 1% to 2% estimated yearly bleeding risk among anticoagulated patients this is a condition that may not infrequently be found in neurointensive care units. Unfortunately, very little prospective data are available concerning the medical management of these cases in the first days after bleeding. The incidence of embolism in the first months after halting anticoagulation therapy is not precisely known, but varies . . . [Full Text of this Article]
THE MAYO EXPERIENCE
SOME OTHER DATA
TAKE-HOME MESSAGES
WHERE DO WE GO FROM HERE?
RELATED ARTICLE
Safety of Discontinuation of Anticoagulation in Patients With Intracranial Hemorrhage at High Thromboembolic Risk
Thanh G. Phan, Merian Koh, and Eelco F. M. Wijdicks
Arch Neurol. 2000;57(12):1710-1713.
ABSTRACT
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
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Barriers to the Use of Anticoagulation for Nonvalvular Atrial Fibrillation: A Representative Survey of Australian Family Physicians
Gattellari et al.
Stroke 2008;39:227-230.
ABSTRACT
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REPRINT: Guidelines for the Management of Spontaneous Intracerebral Hemorrhage in Adults: 2007 Update: A Guideline From the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists.
Broderick et al.
Circulation 2007;116:e391-e413.
ABSTRACT
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Guidelines for the Management of Spontaneous Intracerebral Hemorrhage in Adults: 2007 Update: A Guideline From the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists.
Broderick et al.
Stroke 2007;38:2001-2023.
ABSTRACT
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Management of intracranial bleeding associated with anticoagulation: balancing the risk of further bleeding against thromboembolism from prosthetic heart valves
PHAN et al.
J. Neurol. Neurosurg. Psychiatry 2001;70:820-821.
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