Anticoagulant-associated intracerebral hemorrhage

Abstract

Intracerebral hemorrhage (ICH) is the most dangerous complication of oral anticoagulant treatment (OAT). Up to half of patients with OAT-related ICH experience early clinical deterioration due to active bleeding, leading to hematoma enlargement. Prevention of ICH expansion is therefore one of the primary goals of acute ICH treatment. Blood pressure control and rapid reversal of coagulopathy are the mainstays of acute medical management. Specific reversal agents for vitamin K antagonists, direct thrombin inhibitors, and Factor Xa inhibitors are now available for clinical use, and may improve outcomes when given early enough in the clinical course.

Keywords

• Intracerebral hemorrhage
• Warfarin
• Direct oral anticoagulants
• Reversal