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  • Does therapeutic anticoagulation increase the risk of clinical relevant intracerebral haemorrhage in patients with solid malignancies and brain metastases?

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Editorial commentary
Does therapeutic anticoagulation increase the risk of clinical relevant intracerebral haemorrhage in patients with solid malignancies and brain metastases?
  1. Anna-Katharina Meißner1,
  2. Maximilian Ruge2
  1. 1 Department for General Neurosurgery, Centre of Neurosurgery, University of Cologne, Cologne, Nordrhein-Westfalen, Germany
  2. 2 Department for Stereotaxy and Functional Neurosurgery, Centre of Neurosurgery, University of Cologne, Cologne, Nordrhein-Westfalen, Germany
  1. Correspondence to Prof. Dr Maximilian Ruge, Department for Stereotaxy and Functional Neurosurgery, Centre of Neurosurgery, University of Cologne, Koln 50937, Nordrhein-Westfalen, Germany; Maximilian.ruge{at}uk-koeln.de

https://doi.org/10.1136/jnnp-2021-326029

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    In patients with melanoma brain metastases and previous intracerebral haemorrhage (ICH), anticoagulation bears a significant risk for clinically symptomatic ICH

    Patients with solid malignancies from lung, breast, skin and increasingly from other cancers carry a high risk of developing brain metastases. Particularly with the development of new systemic and personalised medical therapies, the rate of overall survival in these patients is increasing. Patients with cancer, especially those with cerebral involvement, are predisposed to develop venous thromboembolism, requiring therapeutic anticoagulation.1 The application of low-molecular-weighted heparin, warfarin or direct oral anticoagulants (DOACS) presents a risk factor for intralesional and extralesional ICH. ICH may possibly lead to severe neurological impairment, necessity for brain surgery and a consecutive delay of further oncological therapy with impairment of the patient’s …

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    Footnotes

    • Contributors Both authors contributed equally in preparing this editorial.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.

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