Abstract
Spontaneous intracerebral hemorrhage (SICH) with long term oral antiplatelet therapy (LOAPT) is known as a dilemma in balancing the risk of postoperative rebleeding and ischemic events because of confused coagulation function. In this case, the authors reported a 42 year old male SICH patient on LOAPT who received an emergency craniectomy. The thromboelastography suggested that the inhibition of platelet function was high preoperatively. After platelet transfusion during surgery and taking control of the clotting and platelet function postoperatively, the patient was stable without rebleeding and new ischemic events in perioperative period and recovered satisfactorily. The authors presented the importance of monitoring coagulation and platelet function perioperatively for SICH patients on LOAPT. Postoperatively, monitoring and taking control of clotting and platelet function would help in preventing rebleeding and ischemic events in SICH patients on LOAPT; moreover, platelet transfusion may quickly and safely reverse platelet dysfunction for emergency surgery.
Factors Associated with Early Deterioration after Spontaneous Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis
