Aspirin [acetylsalicylic acid (ASA)] is commonly used, either directly or indirectly, to avoid bouts of ischemia. Long-term aspirin use can potentially affect the formation of blood clots during surgery and increase intraoperative blood loss. This is especially important for high-risk surgeries like neurosurgery. The European Society of Cardiology recommends stopping aspirin for at least a week before neurosurgical intervention, but there is currently no clinical data to support this approach. This narrative review provides evidence that raises questions about the necessity of stopping aspirin in neurosurgical patients, as well as a summary of recent clinical data on the bleeding risk associated with chronic aspirin therapy in neurosurgical patients, including brain tumor surgery, cerebrovascular procedures, and spinal surgery.
Aspirin impact monitoring options and their clinical implications are also covered in this article.
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