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01-08-2013 | Original Communication

Intracerebral hemorrhage during anticoagulation with vitamin K antagonists: a consecutive observational study

Authors: S. Horstmann, T. Rizos, M. Lauseker, M. Möhlenbruch, E. Jenetzky, W. Hacke, Th. Steiner, R. Veltkamp

Published in: Journal of Neurology | Issue 8/2013

Abstract

Intracerebral hemorrhage (ICH) is the most devastating complication of oral anticoagulation (OAC). As the number of patients on long-term OAC is expected to rise, the proportion of intracerebral hemorrhage related to OAC (OAC-ICH) in relation to spontaneous ICH (spont-ICH) is expected to increase as well. We determined the proportion of OAC-ICH in consecutive stroke patients and explored differences between OAC-ICH and spont-ICH regarding initial volume, hematoma expansion and outcome. Our prospective study consecutively enrolled patients with supra- and infratentorial ICH. The National Institute of Health Stroke Scale Score and the modified Rankin Scale (mRS) score at baseline and after 3 months, medical history and demographic variables were recorded. All admission and follow-up CTs/MRIs were analysed regarding ICH volume using the ABC/2-method. Intraventricular hemorrhage (IVH) was quantified using the Graeb score. Within 19 months, 2,282 patients were admitted to our ER. 206 ICH patients were included. Overall, 24.8 % of all ICH were related to OAC. Compared to patients with spont-ICH, OAC-ICH patients were older (p = 0.001), more frequently had initial extension of ICH into the ventricles (p = 0.05) or isolated primary IVH (p = 0.03) and a higher Graeb score upon admission (p = 0.01). In contrast, initial ICH volume (p = 0.16) and ICH expansion (p = 0.9) in those receiving follow-up imaging (n = 152) did not differ between the two groups. After correction for age, there was a trend towards poorer outcome in OAC-ICH (p = 0.08). One-fourth of all ICH are related to OAC. Initial extension of ICH into the ventricles and primary IVH are more frequent in OAC-ICH. The rate of hematoma expansion in OAC-ICH patients is similar to non-anticoagulated ICH patients.

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Title: Intracerebral hemorrhage during anticoagulation with vitamin K antagonists: a consecutive observational study
Authors: S. Horstmann
T. Rizos
M. Lauseker
M. Möhlenbruch
E. Jenetzky
W. Hacke
Th. Steiner
R. Veltkamp
Publication date: 01-08-2013
Publisher: Springer Berlin Heidelberg
Published in: Journal of Neurology / Issue 8/2013
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-013-6939-6

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Springer Medicine

Intracerebral hemorrhage during anticoagulation with vitamin K antagonists: a consecutive observational study

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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