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Management of intracranial bleeding associated with anticoagulation: balancing the risk of further bleeding against thromboembolism from prosthetic heart valves
  1. T G PHAN,
  1. Department of Neurology, Mayo Clinic and Foundation, W8A, 200 First Street Southwest, Rochester MN 55905, USA
  1. Professor E F M Wijdicks wijoe{at}

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We read with interest the article by Crawleyet al.1 We respectfully take issue with the authors.

(1) In this article on the management of intracranial bleeding associated with anticoagulation, the authors reported on a patient who had an “intracerebral haematoma” and later developed two new “intracranial haematomas” after heparin therapy. We hope that the authors were referring to either lobar haemorrhage or basal ganglia haemorrhage. If the patient had a subdural haematoma, also classified under intracranial haemorrhage, then a surgical procedure as well as discontinuation of anticoagulation and reversal would have been the preferred treatment.

(2) In their review of the literature, the authors did not discuss …

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