Utilization of recombinant activated factor VII for intracranial hematoma evacuation in coagulopathic nonhemophilic neurosurgical patients with normal international normalized ratios

McClelland, Shearwood; Won, Eun Kyung; Lam, Cornelius H.

doi:10.1007/s12028-007-0040-x

Cited by 9 publications

(5 citation statements)

References 22 publications

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“…Normal INR should not be a deterrent for patients to receive rFVIIa in the setting of strong neurosurgical suspicion for underlying clinical coagulopathy. [ 46 ] There is increased risk of intraoperative bleeding in patients who are on anticoagulants. There is also a risk of complications if anticoagulants are stopped in some patients.…”

Section: Treatmentmentioning

confidence: 99%

Chronic subdural hematoma

et al. 2016

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Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions. There is lack of uniformity in the treatment of CSDH amongst surgeons in terms of various treatment strategies. Clinical presentation may vary from no symptoms to unconsciousness. CSDH is usually diagnosed by contrast-enhanced computed tomography scan. Magnetic resonance imaging (MRI) scan is more sensitive in the diagnosis of bilateral isodense CSDH, multiple loculations, intrahematoma membranes, fresh bleeding, hemolysis, and the size of capsule. Contrast-enhanced CT or MRI could detect associated primary or metastatic dural diseases. Although definite history of trauma could be obtained in a majority of cases, some cases may be secondary to coagulation defect, intracranial hypotension, use of anticoagulants and antiplatelet drugs, etc., Recurrent bleeding, increased exudates from outer membrane, and cerebrospinal fluid entrapment have been implicated in the enlargement of CSDH. Burr-hole evacuation is the treatment of choice for an uncomplicated CSDH. Most of the recent trials favor the use of drain to reduce recurrence rate. Craniotomy and twist drill craniostomy also play a role in the management. Dural biopsy should be taken, especially in recurrence and thick outer membrane. Nonsurgical management is reserved for asymptomatic or high operative risk patients. The steroids and angiotensin converting enzyme inhibitors may also play a role in the management. Single management strategy is not appropriate for all the cases of CSDH. Better understanding of the nature of the pathology, rational selection of an ideal treatment strategy for an individual patient, and identification of the merits and limitations of different surgical techniques could help in improving the prognosis.

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Section: Treatmentmentioning

confidence: 99%

Chronic subdural hematoma

et al. 2016

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“…6 Recombinant activated factor VIIa has also gained popularity for emergency reversal of coagulopathy in patients on anticoagulant therapy requiring urgent surgical intervention even with normalized INR. 7…”

Section: Preoperative Considerationsmentioning

confidence: 99%

Technical Nuances in the Perioperative Management of Chronic Subdural Hematoma by Twin Burr Hole Craniostomy: Tips, Tricks, and Tactics

Sethi,

Harsh,

Kumar

et al. 2024

Indian Journal of Neurotrauma

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Chronic subdural hematoma (CSDH) remains to be the most common neurosurgical entity usually encountered in the elderly population. With an increasing life expectancy and associated comorbidities, the incidence of CSDH is ever increasing. There is a lack of uniformity among neurosurgeons regarding management of CSDH, but surgical evacuation using twin burr hole craniostomy remains to be the most preferred modality. Other options available are twist drill craniostomy and craniotomy. A conservative approach may be preferred in a thin subdural hematoma with no or minimal neurological deficit or in high operative risk patients. Complications such as pneumocephalus, recollection, or rebleeding may be seen following surgical evacuation of CSDH. Herein we aimed to address the technical nuances associated with twin burr hole evacuation of CSDH to reduce the complications and the overall associated morbidity and mortality.

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“…В последующем было описано достаточно большое количество подобных наблюдений, в которых rFVIIa был эффективно использован у нейрохирургических больных с разными видами опухолей для восстановления гемостаза в ходе операций, осложнившихся массивной кровопотерей [77][78][79][80][81]. Эти наблюдения касаются и взрослых, и детей, но у детей, в особенности младшего возраста, ситуация всегда заведомо хуже из-за небольшго объема циркулирующей крови и, как следствие, быстрой декомпенсации системы гемостаза на фоне операционной кровопотери [80][81][82][83][84].…”

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The use of activated recombinant factor VII in neurosurgery

Lubnin

2018

Vopr. neirokhir.

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Список сокращений: ВМК-внутримозговое кровоизлияние КТ-компьютерная томография РКИ-рандомизированное контролируемое исследование САК-субарахноидальное кровотечение СМП-свежезамороженная плазма ЧМТ-черепно-мозговая травма

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Utilization of recombinant activated factor VII for intracranial hematoma evacuation in coagulopathic nonhemophilic neurosurgical patients with normal international normalized ratios

Cited by 9 publications

References 22 publications

Chronic subdural hematoma

Chronic subdural hematoma

Technical Nuances in the Perioperative Management of Chronic Subdural Hematoma by Twin Burr Hole Craniostomy: Tips, Tricks, and Tactics

The use of activated recombinant factor VII in neurosurgery

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