I was interested in the list's initial repsonse to the hpothetical situation
so I was admittedly less than generous with the actual details. In fact the
CT was 2 days after the injury when he self presented beacuse of headaches.
My advice based on it being 2 days after the injury was to leave him
anticoagulated. When I enquired what became of him I was told the surgeons
admitted him and sat on the fence deciding not to give him any more warfarin
but not reverese his anticoagulation. I dont know when they plan (planned)
to restart his warfarin.
Dr John Ryan
----- Original Message -----
From: "Adrian Fogarty" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, October 13, 2002 04:09
Subject: Re: Anticagulation and Head injuries
> Well, I count contusion as early bleeding, it's essentially
> microhaemorrhages. There's a fine line between contusion and haematoma,
and
> the two conditions often co-exist in the same lobe in the same patient.
But
> JR hasn't given us timings which I accept might make a difference. If this
> is a late scan, say six hours or more, then I might be tempted to just
> observe. But if it's an early scan, and his headaches are increasing, I
> would be very tempted to intervene.
>
> AF
>
> ----- Original Message -----
> From: "Rowley Cottingham" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Sunday, October 13, 2002 6:11 AM
> Subject: Re: Anticagulation and Head injuries
>
>
> > He hasn't bled so far. Why should he deteriorate now?
> >
> > Best wishes,
> >
> >
> > Rowley Cottingham
> >
> > [log in to unmask]
> > http://www.emergencyunit.com
> >
>
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