Treatment of Spontaneous Intracerebral Hemorrhage on Aspirin Requiring Emergency Neurosurgery
This protocol covers patients with spontaneous intracerebral hemorrhage who are being treated with aspirin and require emergency neurosurgery for hematoma evacuation — a specific situation where aspirin use raises the concern for postoperative bleeding.
Clinical Situation
When spontaneous ICH occurs in a patient on aspirin and urgent surgical hematoma evacuation is necessary, the perioperative setting calls for a targeted management approach. For this subgroup, the central concern is the elevated risk of postoperative hemorrhage, and the protocol addresses this directly before the patient enters the operating room.
Treatment Approach (Partial Overview)
The management involves a platelet transfusion strategy administered prior to surgery to address the aspirin effect and reduce postoperative bleeding risk.
The complete protocol — including preparation type, timing, and any additional perioperative steps — is available in the full structured regimen below.
Treatment Goals
Reduced postoperative rate and volume of hemorrhage.
References
- For patients with spontaneous ICH being treated with aspirin and who require emergency neurosurgery, platelet transfusion might be considered to reduce postoperative bleeding and mortality.
- Results showed that transfusion of 1 U of previously frozen apheresis platelets before surgery, with or without an additional platelet unit 24 hours later, reduced postoperative rate and volume of hemorrhage.
DOI: 10.1161/STR.0000000000000407
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