Abstract
This chapter reviews the management of all anticoagulation after an intracerebral hemorrhage. Practical guidance on when to start DVT prophylaxis in the early period, and then advice for subacute and late management. Evidence-based management guidance is based on the presumed etiology of the bleed. Through tables reviews the data on the risk of ICH with different antithrombotics. Details what is known about the timing of starting or restarting anticoagulation after ICH.
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References
Fujii Y, et al. Hematoma enlargement in spontaneous intracerebral hemorrhage. J Neurosurg. 2009;80:51–7.
Wada R, et al. CT angiography ‘spot sign’ predicts hematoma expansion in acute intracerebral hemorrhage. Stroke. 2007;38:1257–62.
Ogata T, et al. Deep venous thrombosis after acute intracerebral hemorrhage. J Neurol Sci. 2008;272:83–6.
Dennis M. Effectiveness of intermittent pneumatic compression in reduction of risk of deep vein thrombosis in patients who have had a stroke (CLOTS 3): a multicentre randomised controlled trial. Lancet. 2013;382:516–24.
Bae H, et al. Recurrence of bleeding in patients with hypertensive intracerebral hemorrhage. Cerebrovasc Dis. 1999;9:102–8.
Vermeer SE, Algra A, Franke CL, Koudstaal PJ, Rinkel GJE. Long-term prognosis after recovery from primary intracerebral hemorrhage. Neurology. 2002;59:205–9.
Biffi A, et al. Oral anticoagulation and functional outcome after intracerebral hemorrhage. Ann Neurol. 2017;82:755–65.
Hemphill JC III, Greenberg SM, Anderson CS, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015;46:2032–60.
Eckman MH, Rosand J, Knudsen KA, Singer DE, Greenberg SM. Can patients be anticoagulated after intracerebral haemorrhage? A decision analysis. Stroke. 2003;34:1710–6.
Zhang H, et al. Prevalence of superficial Siderosis in patients with cerebral amyloid Angiopathy. Neurology. 2010;74:1346–50.
Charidimou A, et al. Cortical superficial siderosis and intracerebral hemorrhage risk in cerebral amyloid angiopathy. Neurology. 2013;81:1666–73.
Wilson D, et al. Recurrent stroke risk and cerebral microbleed burden in ischemic stroke and TIA. Neurology. 2016;87(14):1501–10.
Poli D, et al. Recurrence of ICH after resumption of anticoagulation with VK antagonists: CHIRONE Study. Neurology. 2014;82:1020–6.
Gorelick PB, Weisman SM. Risk of hemorrhagic stroke with aspirin use: an update. Stroke. 2005;36:1801–7.
Viswanathan A, et al. Antiplatelet use after intracerebral hemorrhage. Neurology. 2006;66:206–9.
Ruff CT, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet. 2014;383:955–62.
Hart RG, et al. Intracranial hemorrhage in atrial fibrillation patients during anticoagulation with warfarin or dabigatran: the RE-LY trial. Stroke. 2012;43:1511–7.
Majeed A, Kim Y-K, Roberts RS, Holmström M, Schulman S. Optimal timing of resumption of warfarin after intracranial hemorrhage. Stroke. 2010;41:2860–6.
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Gutierrez, J.C.M. (2022). Intracranial Hemorrhage – Management of Anticoagulation. In: Albin, C.S., Zafar, S.F. (eds) The Acute Neurology Survival Guide. Springer, Cham. https://doi.org/10.1007/978-3-030-75732-8_40
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DOI: https://doi.org/10.1007/978-3-030-75732-8_40
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