Race Against the Clock: Overcoming Challenges in the Management of Anticoagulant-Associated Intracerebral Hemorrhage
Release Date: August 1, 2014
Last Review: October 25, 2013
Expiration Date: July 31, 2015
Estimated Time to Complete this CME Activity: 1.5 hours
Media/Method of Participation: Journal Article, Web-based posttest, and evaluation
Hardware/Software Requirements: Any Web browser

*This activity expired for credit on July 31, 2015 and is no longer available for credit
This activity has been designed to meet the educational needs of neurosurgeons, residents, fellows, neurosurgical nurses, and physician assistants interested in the practice and business of neurosurgery.
Neurosurgeons are intimately involved in the emergency management of anticoagulant-treated patients who present with an intracerebral hemorrhage requiring urgent correction of their coagulopathy to prevent worsening hemorrhage and to facilitate surgical intervention as necessary. A number of therapies have been used alone or in combination for the treatment of anticoagulant-associated intracerebral hemorrhage (AAICH) to reverse anticoagulation in order to achieve hemodynamic stability, limit hematoma expansion, and prepare the patient for potential neurologic surgery. Given the essential role of the neurosurgeon, in consult with the emergency department physician, in managing these patients, this enduring activity will elucidate warfarin reversal strategies (and related current controversies) with available and soon-to-be-available therapies for the management of AAICH, and the importance of timely intervention in order to achieve successful reversal of warfarin-induced coagulopathy.
Upon proper completion of this enduring material, participants should be better able to:
  • Appropriately apply evidence-based guidelines and strategies to the management of patients with warfarin-associated ICH.
  • Recognize the barriers to successful management of patients with ICH in the context of anticoagulation-associated coagulopathy.
  • Based on risk/benefit analysis of reversal agents, select appropriate therapies for the treatment of patients with AAICH.
Peter Le Roux, MD, FACS
Professor of Neurosurgery
Thomas Jefferson University
Philadelphia, PA
Co-Director, Brain and Spine Center
Lankenau Medical Center
Wynnewood, PA
Charles V. Pollack, Jr, MA, MD, FACEP
Department of Emergency Medicine
Perelman School of Medicine
University of Pennsylvania
Chairman, Department of Emergency Medicine
Pennsylvania Hospital
Philadelphia, PA

Melissa Milan, MD
Alisa Schaefer, PhD
Paradigm Medical Communications, LLC is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Paradigm Medical Communications, LLC designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The American Association of Neurological Surgeons accepts these AMA PRA Category 1 CreditsTM toward the Continuing Education Award in Neurosurgery to maintain membership in the AANS and toward the ABNS Maintenance of Certification program.

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  • Register or log in at to complete and submit the online posttest and evaluation OR complete the posttest/evaluation form at the end of the article and mail or fax it to Paradigm Medical Communications, LLC, 523 Route 303, Orangeburg, NY 10962; fax (845) 398-5108.
  • Answer 70% of the posttest questions correctly to earn credit. Online completion of the posttest allows unlimited opportunities to successfully complete the posttest.
Following online completion of the posttest and evaluation, a certificate of participation will be available for download/printing immediately. Participants who submit a posttest/evaluation form via mail or fax will receive an email with a link to their certificate of participation within 1 to 2 weeks following receipt of completed form.
For additional questions regarding CME credit, please contact the CME Department of Paradigm Medical Communications, LLC,at (845) 398-5946.
This CME activity is supported by an educational grant from CSL Behring.
In accordance with Accreditation Council for Continuing Medical Education requirements on disclosure, faculty and contributors are asked to disclose any relationships with commercial interests associated with the area of medicine featured in the activity. These relationships are described below.
Peter Le Roux, MD, FACS
Retained Consultant: Integra LifeSciences; Codman & Shurtleff, Inc.; Synthes, Inc.
Speakers Bureau: Integra LifeSciences
Contracted Research: Integra LifeSciences
Charles V. Pollack, Jr, MA, MD, FACEP
Consultant: Astra-Zeneca; Boehringer Ingelheim Pharmaceuticals, Inc; Bristol-Myers Squibb; Daiichi Sankyo, Inc; Janssen Pharmaceuticals, Inc; Pfizer Inc; Sanofi-Aventis U.S. LLC.
Scientific Directors, Melissa Milan, MD, and Alisa Schaefer, PhD have no financial conflicts to disclose.
Paradigm Medical Communications, LLC staff members have no financial conflicts to disclose.

Sean D. Lavine, MD-Independent Peer Reviewer
Director, Endovascular Neurosurgery
Columbia Presbyterian Medical Center
New York, NY
Secretary, AANS/CNS Executive Council of Cerebrovascular Surgery
No financial conflicts to disclose.
Jack E. Ansell, MD-Independent Peer Reviewer
Professor of Medicine
Hofstra North Shore/LIJ
School of Medicine
New York, NY
Advisory Board: Boehringer Ingelheim Pharmaceuticals, Inc; Bristol-Myers Squibb; Daiichi Sankyo, Inc; Janssen Pharmaceuticals, Inc; Perosphere Inc; Pfizer Inc
Shareholder: Perosphere Inc
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