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Current Treatment Options in Neurology
Published in: Current Treatment Options in Neurology 2/2010

01-03-2010 | Critical Care Neurology

Treatment of Coagulopathy in Intracranial Hemorrhage

Authors: Maria I. Aguilar, MD, William D. Freeman, MD

Published in: Current Treatment Options in Neurology | Issue 2/2010

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Opinion statement

Intracranial hemorrhage (ICH) complicated by coagulopathy is a medical emergency, which can delay neurosurgical intervention, lead to larger hematoma size, and increase mortality until the coagulopathy is corrected. Prompt recognition of coagulopathy during ICH is essential for correct, rapid treatment to reduce ongoing bleeding and improve survival. The proper treatment of a coagulopathic ICH patient is centered on rapid identification of the coagulopathic defect and correction of the underlying coagulopathy to stop acute bleeding. Patients with coagulopathic ICH require admission to a neuro-intensive unit care with management of airway, oxygenation, and systemic arterial and cerebral perfusion pressure; optimization of serum glucose; aggressive treatment of fever; and rehabilitation. Once the coagulopathic defect is reversed, some patients benefit from emergent neurosurgical intervention to prevent secondary brain injury from raised intracranial pressure, hydrocephalus, or mass effect. The management of ICH patients prescribed common antithrombotics such as aspirin, clopidogrel, warfarin, or heparin, as well as thrombolytic agents such as tissue plasminogen activator, is the focus of this review.
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Metadata
Title
Treatment of Coagulopathy in Intracranial Hemorrhage
Authors
Maria I. Aguilar, MD
William D. Freeman, MD
Publication date
01-03-2010
Publisher
Current Science Inc.
Published in
Current Treatment Options in Neurology / Issue 2/2010
Print ISSN: 1092-8480
Electronic ISSN: 1534-3138
DOI
https://doi.org/10.1007/s11940-010-0061-1

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