Perioperative transient ischemic attack caused by the cessation of warfarin.

[locked-in syndrome]

This paper describes the circumstances of a patient who had been receiving long -term warfarin treatment , but ceased it prior to surgical operation , sustained a transient ischemic heart attack post-operatively , which eventuated in delayed extubation and locked-in syndrome . For patients at low risk of perioperative bleeding , anticoagulation with oral vitamin K antagonist can probably be able to maintain the therapeutic range (INR ≤ 2 .0 ) extreme . For patients with a high risk of bleeding , the international normalized ratio (INR ) should be kept ≤ 1 .5 . Within this range , patients at low risk of thrombosis can discontinue warfarin treatment for 2 -5 days pre-operatively ; patients at high risk for thrombosis can stop warfarin but should probably be treated with intravenous or subcutaneous heparin when the INR is subtherapeutic .

Diseases
Validation

Diseases presenting "low risk" symptom

achondroplasia

congenital diaphragmatic hernia

esophageal adenocarcinoma

heparin-induced thrombocytopenia

hodgkin lymphoma, classical

locked-in syndrome

primary hyperoxaluria type 1

sneddon syndrome

waldenström macroglobulinemia

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