Aspririn effectively knocks cyclooxygenase-I (COX-1) enzyme irreversibly by protein acetylation. Let’s talk a few minutes to discuss one such practice in the arena of intracranial hemorrhage. It never ceases to amaze me how little research is out there especially when we try to subscribe to certain practice standards. Neurosurgery is contact immediately…oh yeah…he is on aspirin…how do I stop the effects of the world’s best known drug? Head CT is performed as quickly as possible and you find a large subdural bleed with midline shift.
His sensation and strength are all intact. His medications include metoprolol, aspirin and zocor. He reports to you that he had some numbness of his tongue but that symptom has resolved. He is not one to have headaches and his wife reports that he is a little “off”. 70 y m reports to the emergency room with a past medical history of hypertension and high cholesterol complaining of headache.
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