{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T05:10:03Z","timestamp":1738905003470,"version":"3.37.0"},"reference-count":0,"publisher":"American Academy of Audiology","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["j am acad audiol"],"published-print":{"date-parts":[[2008,3,1]]},"abstract":"<jats:p>Elderly patients with balance problems are at high risk for falls. When these same patients are also on anticoagulants, the consequences of a fall can be serious. Anticoagulant therapy increases the risk of cerebral hemorrhage. Even mild head trauma can cause a fatal cerebral hemorrhage\n when anticoagulants are used. However, this risk needs to be weighed against the possibility of spontaneous stroke. The decision to choose anticoagulant therapy can become even more complicated if the patient has an increased risk of falling. A case is presented of an 87-year-old female with\n balance problems, in part from a small unilateral vestibular schwannoma. She was also receiving Coumadin anticoagulant therapy. When she began to fall, a decision had to be made about the relative risks and benefits of Coumadin therapy. The risk\/benefit calculation could change, however, depending\n on whether her fall risk could be improved. This article presents the diagnostic test results and medical opinions surrounding this case. The importance of assessing patients' overall situation is stressed in planning rehabilitation. Los pacientes ancianos con problemas del equilibrio tienen\n un alto riesgo para ca\u00eddas. Cuando esos mismos pacientes toman anticoagulantes, las consecuencias de una ca\u00edda pueden ser serias. La terapia anticoagulante aumenta el riesgo de una hemorragia cerebral. A\u00fan un trauma cef\u00e1lico leve puede causar una hemorragia cerebral\n fatal cuando se usan anticoagulantes. Sin embargo, este riesgo debe ser ponderado contra la posibilidad de una apoplej\u00eda espont\u00e1nea. La decisi\u00f3n de escoger una terapia anticoagulante puede volverse a\u00fan m\u00e1s complicada si el paciente tiene un riesgo aumentado\n de ca\u00eddas. Se presenta un caso de una mujer de 87 a\u00f1os de edad con problemas de equilibrio, en parte por un peque\u00f1o schwanoma vestibular unilateral. Ella tambi\u00e9n estaba recibiendo terapia con el anticoagulante Coumadin. Cuando ella empez\u00f3 a caerse, se tuvo\n que tomar una decisi\u00f3n sobre el riesgo relativo y los beneficios de la terapia con Coumadin. El c\u00e1lculo del riesgo\/beneficio podr\u00eda cambiar, sin embargo, dependiendo de si su riesgo para ca\u00eddas puede ser mejorado. Este art\u00edculo presenta los resultados de\n las pruebas diagn\u00f3sticas y las opiniones m\u00e9dicas al respecto del caso. La importancia de evaluar la situaci\u00f3n global del paciente se enfatiza a la hora de planear la rehabilitaci\u00f3n.<\/jats:p>","DOI":"10.3766\/jaaa.19.3.8","type":"journal-article","created":{"date-parts":[[2008,7,19]],"date-time":"2008-07-19T21:26:34Z","timestamp":1216502794000},"page":"237-245","source":"Crossref","is-referenced-by-count":8,"title":["Fall Risk, Vestibular Schwannoma, and Anticoagulation Therapy"],"prefix":"10.3766","volume":"19","author":[{"given":"Janet","family":"Shelfer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Zapala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larry","family":"Lundy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2087","container-title":["Journal of the American Academy of Audiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/aaa\/jaaa\/2008\/00000019\/00000003\/art00008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T07:55:04Z","timestamp":1738828504000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.3766\/jaaa.19.3.8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,3,1]]},"references-count":0,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2008,3,1]]}},"alternative-id":["1050-0545(20080301)19:3L.237;1-"],"URL":"https:\/\/doi.org\/10.3766\/jaaa.19.3.8","relation":{},"ISSN":["1050-0545"],"issn-type":[{"type":"print","value":"1050-0545"}],"subject":[],"published":{"date-parts":[[2008,3,1]]}}}