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Health Dictionary

Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Epidural hematoma medical therapy

Introduction

Overview

Overview

The mainstay of treatment for epidural hematoma is urgent surgery.

Medical Therapy

Medical Therapy

  • The mainstay of treatment for epidural hematoma is urgent surgery.[1]
  • In patients with uncontrolled or life-threatening bleeding (such as progressive epidural hematoma); who are taking apixaban or rivaroxaban, reversal of anti-coagulation may be done by Andexanet alfa.[2][3][4][5][6]
    • Andexanet alfa Dosing Regimens: Low dose: 400 mg IV bolus administered at a rate of ~30 mg/minute, followed 2 minutes later by 4 mg/minute IV infusion for up to 120 minutes High dose: 800 mg IV bolus administered at a rate of ~30 mg/minute, followed 2 minutes later by 8 mg/minute IV infusion for up to 120 minutes
References

References

  1. ↑ Maugeri R, Anderson DG, Graziano F, Meccio F, Visocchi M, Iacopino DG (2015). “Conservative vs. Surgical Management of Post-Traumatic Epidural Hematoma: A Case and Review of Literature”. Am J Case Rep. 16: 811–7. PMC 4652627. PMID 26567227.
  2. ↑ Lu G, DeGuzman FR, Hollenbach SJ, Karbarz MJ, Abe K, Lee G; et al. (2013). “A specific antidote for reversal of anticoagulation by direct and indirect inhibitors of coagulation factor Xa”. Nat Med. 19 (4): 446–51. doi:10.1038/nm.3102. PMID 23455714.
  3. ↑ Connolly SJ, Milling TJ, Eikelboom JW, Gibson CM, Curnutte JT, Gold A; et al. (2016). “Andexanet Alfa for Acute Major Bleeding Associated with Factor Xa Inhibitors”. N Engl J Med. 375 (12): 1131–41. doi:10.1056/NEJMoa1607887. PMC 5568772. PMID 27573206.
  4. ↑ Nafee T, Aslam A, Chi G, Pahlavani S, Nimri D, Kuchkuntla AR; et al. (2017). “Andexanet alfa for the reversal of anticoagulant activity in patients treated with direct and indirect factor Xa inhibitors”. Expert Rev Cardiovasc Ther. 15 (4): 237–245. doi:10.1080/14779072.2017.1305889. PMID 28282497.
  5. ↑ Connolly SJ, Gibson CM, Crowther M (2016). “Andexanet Alfa for Factor Xa Inhibitor Reversal”. N Engl J Med. 375 (25): 2499–500. doi:10.1056/NEJMc1613270. PMID 28002711.
  6. ↑ Lu G, Pine P, Leeds JM, DeGuzman F, Pratikhya P, Lin J; et al. (2018). “Andexanet alfa effectively reverses edoxaban anticoagulation effects and associated bleeding in a rabbit acute hemorrhage model”. PLoS One. 13 (3): e0195122. doi:10.1371/journal.pone.0195122. PMC 5874076. PMID 29590221.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]