title: 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 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.
authors.affiliation: Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Boston.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Weinstock
authors.affiliation: Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston.
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Uhlmann
authors.affiliation: Division of Hematology-Oncology, Division of Hemostasis and Thrombosis, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston. Electronic address: jzwicker@bidmc.harvard.edu.
authors.forename: Jeffrey I
authors.initials: JI
authors.lastname: Zwicker
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D001777:Blood Coagulation / Q000187:drug effects; D001921:Brain / Q000098:blood supply / Q000187:drug effects / Q000503:physiopathology; D001932:Brain Neoplasms / Q000097:blood / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D020300:Intracranial Hemorrhages / Q000139:chemically induced* / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D054556:Venous Thromboembolism / Q000097:blood / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D000925:Anticoagulants
keywords: Anticoagulation; Brain metastases; Intracranial hemorrhage