Intracranial hemorrhage in cancer patients treated with anticoagulation

ABSTRACT Both venous thromboembolism and intracranial metastases are common complications in the setting of primary brain tumors and metastatic malignancies. Anticoagulation is indicated in the presence of cancer-associated thrombosis in order to limit the risk of pulmonary embolism; however, there...

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Bibliographic Details
Published in:Thrombosis research 2016-04, Vol.140, p.S60-S65
Main Authors: Weinstock, Matthew J, Uhlmann, Erik J, Zwicker, Jeffrey I
Format: Article
Language:English
Subjects:
Anticoagulants - adverse effects
Anticoagulants - therapeutic use
Anticoagulation
Blood Coagulation - drug effects
Brain - blood supply
Brain - drug effects
Brain - physiopathology
Brain metastases
Brain Neoplasms - blood
Brain Neoplasms - complications
Brain Neoplasms - drug therapy
Brain Neoplasms - physiopathology
Hematology, Oncology and Palliative Medicine
Humans
Intracranial hemorrhage
Intracranial Hemorrhages - chemically induced
Intracranial Hemorrhages - complications
Intracranial Hemorrhages - physiopathology
Intracranial Hemorrhages - therapy
Venous Thromboembolism - blood
Venous Thromboembolism - complications
Venous Thromboembolism - drug therapy
Venous Thromboembolism - physiopathology
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Summary:ABSTRACT Both venous thromboembolism and intracranial metastases are common complications in the setting of primary brain tumors and metastatic malignancies. Anticoagulation is indicated in the presence of cancer-associated thrombosis in order to limit the risk of pulmonary embolism; however, there is reluctance to initiate anticoagulation in the setting of intracranial metastatic disease due to potential for intracranial hemorrhage. Recent evidence suggests that therapeutic anticoagulation can be safely administered in the setting of metastatic brain tumors. This review examines the current understanding of the pathophysiology of intracranial hemorrhage in malignancy, describes the incidence of intracranial hemorrhage in the setting of brain tumors with therapeutic anticoagulation, and outlines management strategies relevant to the treatment of intracranial hemorrhage in the setting of anticoagulation.
ISSN:0049-3848
1879-2472
DOI:10.1016/S0049-3848(16)30100-1