Anticoagulation and Hemostasis in Neurosurgery

Christopher M. Loftus, MD, Dr.h.c., FACS, is Professor and Chairman, Department of Neurosurgery, and Professor of Neurology at Loyola University Stritch School of Medicine, Maywood, IL, USA. His previous appointments include Professor and Chairman, Department of Neurosurgery, Temple University School of Medicine, Philadelphia, PA; The Harry Wilkins Professor and Chairman and The Esther and Ted Greenberg Professor and Chairman, Department of Neurosurgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK; and Professor of Surgery (Neurosurgery), The University of Iowa College of Medicine, Iowa City, IA. Dr. Loftus is a Diplomate of the National Board of Medical Examiners and the American Board of Neurological Surgery. He has held many offices in leading professional bodies, including Vice Presidency of the American Association of Neurological Surgeons, and he is currently Treasurer of the World Federation of Neurosurgical Societies. His research interests include intracranial collateral circulation, extracranial carotid occlusive disease, and responses of cerebral blood flow to cerebral revascularization. He is participating in the IHAST cooperative trial for hypothermia in aneurysm surgery and the ISUIA - unruptured aneurysm trial. Dr. Loftus has been a member of the editorial boards of many prestigious journals and is the author of more than 200 articles and book chapters in peer-reviewed publications. He has edited or authored over twenty previous books, including, most recently, Intraoperative Neuromonitoring (McGraw-Hill, New York, 2013; co-editors Biller J and Baron EF).

Part1.  General Principles.- Physiology of Hemostasis.- LaboratoryAssessment of Physiologic and Pathologic Hemostasis.- Current AnticoagulationDrugs and Mechanisms of Action.- Reversal of Target-Specific OralAnticoagulants.- Overview, Treatment, Measurement, and Modification of PlateletFunction.- Role of Antiplatelet Therapy in Neurosurgery: Efficacy and SafetyProfiles.- Part 2.  Coagulation IssuesAcross all Patient Spectrums.- Congenital Coagulation Disorders.- AcquiredCoagulation Disorders.- Regulation and Dysregulation of Fibrinolysis.- RisksAssociated with Administration of Allogeneic Blood Components.- CommonCoagulation Disorders That May Arise Intraoperatively.- Evaluation andManagement of Untoward Intraoperative Bleeding.- Treatment of DisseminatedIntravascular Coagulation (DIC).- Heparin-Induced Thrombocytopenia (HIT).- Anticoagulationin Cardiovascular Diseases.- Workup and Treatment of Pulmonary Embolus .- Part3.  Coagulation Issues Specific toNeurosurgery.- Classes of Drugs and Blood Products for Acute Reversal ofAnticoagulant Effect.- Rescue Strategies to Facilitate Emergency Neurosurgery inPatients on Antiplatelet or Anticoagulant Agents.- Considerations forCoagulation in the Multi-Trauma Patient.- Cerebral Venous Sinus Thrombosis.- CoagulationStudies in Preoperative Neurosurgery Patients.- Safe Strategies for GradualSuspension and Re-institution of Anticoagulation to Permit Elective Surgery.- SpontaneousIntracerebral Hemorrhage due to Coagulation Disorders.- Prophylactic Screeningfor Venous Thromboembolism in NeurosurgicalPatients.- Venous ThromboembolismProphylaxis in Neurosurgery.- Can Patients with Known Intracranial and IntraspinalVascular Lesions be Anticoagulated?.- Intrathecal Access and Devices inPatients on Antiplatelet or Anticoagulant Therapy.- Is it Safe to ShuntAnti-coagulated NPH Patients?.- Surgical Hemostasis in the Era ofAnticoagulation: Guidelines and Recommendations Summary.