Warfarin is widely used in the prevention and treatment of thromboembolic disorders. In patients receiving anticoagulation treatment, about 10% of them may have surgical or invasive procedures each year. It is important to evaluate the risk of bleeding or thromboembolism with continuing or discontinuing warfarin therapy for the procedures. We report a case with severe brain embolism suspected to be related to prolonged discontinued warfarin treatment and discuss the perioperative warfarin management. We advocate more inter-disciplinary cooperation and communication, and sharing patients' health information among health care settings to improve treatment outcome.
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