A 65-year-old man on ICU has chronic subdural haematoma causing midline shift and reduced GCS. He is on warfarin with INR 3.2. The neurosurgical team ...

Question

A 65-year-old man on ICU has chronic subdural haematoma causing midline shift and reduced GCS. He is on warfarin with INR 3.2. The neurosurgical team plans burr hole drainage. In addition to INR reversal with PCC and vitamin K, what specific perioperative consideration is important?

Accepted Answer

Ensure INR is corrected to

Answer

Administer prophylactic antibiotics only

Answer

Post-operative ICP monitoring is mandatory in all cases

Answer

Warfarin should never be restarted after subdural haematoma

Answer

CT head post-operatively is unnecessary

uk-fficm MCQ (SBA): Anticoagulated Subdural Haematoma

A 65-year-old man on ICU has chronic subdural haematoma causing midline shift and reduced GCS. He is on warfarin with INR 3.2. The neurosurgical team plans burr hole drainage. In addition to INR reversal with PCC and vitamin K, what specific perioperative consideration is important?