Resuming antiplatelet therapy following a subdural hematoma presents a complex clinical decision-making scenario. The decision hinges on balancing the risk of recurrent hemorrhage against the potential for thromboembolic events, particularly in patients with underlying cardiovascular or cerebrovascular disease. Considerations include the size and stability of the hematoma, the patient’s overall risk profile, and the indication for antiplatelet medication.
The avoidance of thromboembolic complications is a primary concern in patients requiring antiplatelet agents. Premature cessation can lead to significant morbidity and mortality. However, restarting such medications too early after a subdural hematoma increases the risk of rebleeding and subsequent neurological deterioration. Historically, management was often conservative, involving prolonged antiplatelet discontinuation, but more recent data suggest earlier resumption may be considered in carefully selected patients.
