Intracranial hemorrhage in patients taking oral anticoagulants. Current possibilities for therapy

Abstract

The paper reviews an update on the possibilities of providing care for patients with spontaneous non-traumatic intracranial hemorrhage (ICH) developing in patients with atrial fibrillation who use oral anticoagulants. The incidence of ICH is shown to be considerably lower when nonvitamin K-dependent anticoagulants (NOACs) are used, but the hematoma evolution scenarios do not differ between the groups of patients receiving vitamin K antagonists or NOACs. The results of studies assessing hypertension therapy in patients with ICH are compared. The possibilities of using various reversal agents for various oral anticoagulants are also discussed. Since one of the main problems associated with increased mortality and severe disabilities is the progression rate of ICH, the possibility of using a specific antagonist can determine the choice of an anticoagulant for the primary prevention of ischemic stroke in a patient with atrial fibrillation.

Keywords

• atrial fibrillation
• stroke prevention
• intracranial hemorrhage
• oral anticoagulants
• new oral anticoagulants
• direct oral anticoagulants
• vitamin k antagonists
• specific antagonist
• dabigatran
• idarucizumab