Abstract
This case describes ICH associated with oral anticoagulation (OAC-ICH). This is one of the serious side effects of these drugs with a high mortality – making them a particularly lethal form of stroke. The increase in mortality is attributable to continued haematoma expansion, so the initial aim of management is to reverse the coagulopathy as quickly as possible. The recent introduction of new oral anticoagulant drugs has made the management of ICH more complex as they are irreversible in action. Another dimension to the management of OAC-ICH is the management of elevated blood pressure which is explored in the discussion of this case.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Balami JS, Buchan AM. Complications of intracerebral haemorrhage. Lancet Neurol. 2012;11(1):101–18.
Davis SM, Broderick J, Hennerici M, et al. Hematoma growth is a determinant of mortality and poor outcome after intracerebral hemorrhage. Neurology. 2006;66:1175–81.
Delgado Almandoz JE, Yoo AJ, Stone MJ, et al. The spot sign score in primary intracerebral hemorrhage identifies patients at highest risk of in-hospital mortality and poor outcome among survivors. Stroke. 2010;41:54–60.
Hart RG, Boop B, Anderson DC. et al. Oral anticoagulants and intracerebral haemorrhage: facts and hypotheses. Stroke. 1995;26:1471–7.
Stenier T, Rosand J, Diringer M. et al. Intracerebral haemorrhage associated with oral anticoagulant therapy. Stroke. 2006;37:256–62.
Lovelock C, Cordonnier C, Naka H, et al. Antithrombotic drug use, cerebral microbleeds and intracerebral haemorrhage. Stroke. 2010;41:1222–8.
Anderson CS, Heeley E, Huang Y, et al. Rapid blood pressure lowering in patients with acute intracerebal haemorrhage. N Engl J Med. 2013;368:2355–65.
Mendelow AD, Gregson BA, Rowan EN, et al. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas (STICH II): a randomised trial. Lancet. 2013;382(9890):397–408.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer-Verlag London
About this chapter
Cite this chapter
Gill, S.K., Werring, D.J. (2015). Intracerebral Haemorrhage and Oral Anticoagulants. In: Gill, S., Brown, M., Robertson, F., Losseff, N. (eds) Stroke Medicine. Springer, London. https://doi.org/10.1007/978-1-4471-6705-1_39
Download citation
DOI: https://doi.org/10.1007/978-1-4471-6705-1_39
Publisher Name: Springer, London
Print ISBN: 978-1-4471-6704-4
Online ISBN: 978-1-4471-6705-1
eBook Packages: MedicineMedicine (R0)