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Spontaneous Intracerebral Hemorrhage Due to Coagulation Disorders

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Anticoagulation and Hemostasis in Neurosurgery

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Abstract

Patients on oral anticoagulants are at risk of intracerebral hemorrhage (ICH), and have larger hematomas compared to patients without coagulopathy. Mortality in these patients exceeds 50 %, likely due to hematoma expansion. Although quality, high-level evidence from randomized controlled trials is lacking, current guidelines recommend replacement of vitamin K-dependent factors and correction of INR with vitamin K, fresh-frozen plasma (FFP), or prothrombin complex concentrates (PCC) immediately to prevent hematoma expansion. Intensive blood pressure reduction may also improve clinical outcomes.

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Authors and Affiliations

  1. Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143, USA

    W. Caleb Rutledge M.D. & Michael T. Lawton M.D.

  2. Department of Neurology, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143, USA

    S. Andrew Josephson M.D.

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Correspondence to Michael T. Lawton M.D. .

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  1. Stritch School of Medicine, Loyola University, Maywood, Illinois, USA

    Christopher M. Loftus

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Rutledge, W.C., Josephson, S.A., Lawton, M.T. (2016). Spontaneous Intracerebral Hemorrhage Due to Coagulation Disorders. In: Loftus, C. (eds) Anticoagulation and Hemostasis in Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-27327-3_23

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