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oral anticoagulant therapy

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Chapter 14 - Surgical management of intracerebral hemorrhage
- By A. David Mendelow
Edited by J. Ricardo Carhuapoma, Stephan A. Mayer, Columbia University, New York, Daniel F. Hanley
Book:

Intracerebral Hemorrhage

Published online:

04 May 2010

Print publication:

12 November 2009, pp 165-175
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Summary

This chapter focuses on the epidemiology of oral anticoagulant therapy (OAT)-associated ICH, its pathophysiology, and treatment options based on the currently available data. One of the most common indications for OAT is to prevent stroke in patients with atrial fibrillation. Intracerebral hemorrhage is the deadliest form of stroke, with a mortality rate between 30% and 55%. The incidence and dynamics of hematoma expansion in OAT-ICH remain to be established. Current data suggest that the natural course of hematoma expansion in this group of patients is more prolonged as compared to spontaneous ICH. This may provide a longer time window for treatment of OAT-ICH. However, in OAT-ICH the underlying coagulopathy prolongs the time course of bleeding or rebleeding, and repeated dosing or a higher dose might be essential. The risk of thromboembolism that is associated with current hemostatic treatment strategies which aim to normalize coagulation is unknown.

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Chapter 14 - Surgical management of intracerebral hemorrhage

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Chapter 14 - Surgical management of intracerebral hemorrhage

Summary