Aspirin interruption before neurosurgical interventions: A controversial problem

Area of Science:

• Neurosurgery
• Cardiology
• Pharmacology

Background:

• Aspirin is common for preventing ischemic events.
• Chronic aspirin use may increase surgical bleeding risk.
• Neurosurgical guidelines recommend aspirin cessation 7 days prior, lacking strong evidence.

Purpose of the Study:

• To review evidence challenging the necessity of aspirin interruption before neurosurgery.
• To discuss aspirin effect monitoring and its clinical implications.
• To summarize bleeding risk data for aspirin users undergoing neurosurgery.

Main Methods:

• Narrative review of existing literature.
• Analysis of clinical data on aspirin and bleeding in neurosurgical patients.
• Evaluation of aspirin effect monitoring techniques.

Main Results:

• Evidence suggests aspirin interruption may not be necessary for all neurosurgical patients.
• Aspirin effect monitoring offers options for managing perioperative risk.
• Bleeding risk varies across different neurosurgical procedures (brain tumors, cerebrovascular, spinal).

Conclusions:

• Current guidelines for aspirin interruption before neurosurgery may be overly cautious.
• Personalized management based on aspirin effect monitoring and procedure type is warranted.
• Further research is needed to refine recommendations for aspirin use in neurosurgery.