{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:34:10Z","timestamp":1740126850699,"version":"3.37.3"},"reference-count":72,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Neurol"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>While anticoagulation and its reversal have been of clinical relevance for decades, recent academic and technological advances have expanded the repertoire of its application in neurological disease. The advent of direct oral anticoagulants provides effective, mechanistically elegant, and relatively safer therapeutic options than warfarin for eligible patients at risk for neurological sequelae of prothrombotic states, particularly given the recent availability of corresponding reversal agents. In this review, we examine the provenance, indications, safety, and reversal tools for anticoagulant medications in the context of neurological disease, with specific attention to acute ischemic stroke, cerebral venous sinus thrombosis, and intracerebral hemorrhage. We will use specific clinical scenarios to illustrate the complex factors that must be considered in the use of anticoagulation, including intracranial pathology such as intracerebral hemorrhage, traumatic brain injury, or malignancy; metabolic complications such as chronic kidney disease; pregnancy; and advanced age.<\/jats:p>","DOI":"10.1055\/s-0041-1733793","type":"journal-article","created":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T22:34:42Z","timestamp":1633646082000},"page":"530-540","source":"Crossref","is-referenced-by-count":0,"title":["Anticoagulation in Acute Neurological Disease"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6617-567X","authenticated-orcid":false,"given":"Cina","family":"Sasannejad","sequence":"additional","affiliation":[{"name":"Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin N.","family":"Sheth","sequence":"additional","affiliation":[{"name":"Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,10,7]]},"reference":[{"issue":"02","key":"ref1","first-page":"175","article-title":"The evolution of anticoagulant therapy","volume":"14","author":"M Franchini","year":"2016","journal-title":"Blood Transfus"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1161\/01.STR.17.1.111","article-title":"Hemorrhagic complications of long-term anticoagulant therapy for ischemic cerebral vascular disease","volume":"17","author":"M Levine","year":"1986","journal-title":"Stroke"},{"issue":"12","key":"ref3","doi-asserted-by":"crossref","first-page":"857","DOI":"10.7326\/0003-4819-146-12-200706190-00007","article-title":"Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation","volume":"146","author":"R G Hart","year":"2007","journal-title":"Ann Intern Med"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/S1474-4422(09)70340-0","article-title":"Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis","volume":"9","author":"C JJ van Asch","year":"2010","journal-title":"Lancet Neurol"},{"issue":"08","key":"ref5","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1016\/j.amjcard.2013.05.063","article-title":"Estimates of current and future incidence and prevalence of atrial fibrillation in the U.S. adult population","volume":"112","author":"S Colilla","year":"2013","journal-title":"Am J Cardiol"},{"issue":"13","key":"ref6","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1001\/archinte.1994.00420130036007","article-title":"Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation. 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