Stroke, Vol 21, 726-730, Copyright © 1990 by American Heart Association
CL Franke, J de Jonge, JC van Swieten, AA Op de Coul and J van Gijn
We retrospectively studied 79 patients from three centers who suffered an
intracerebral hemorrhage during treatment with anticoagulants and compared
them with 84 patients from one center who suffered a spontaneous
intracerebral hemorrhage without anticoagulant treatment. Mortality after
30 days was slightly higher in patients with anticoagulant treatment (67%)
than in those without (55%), and the proportion of patients who attained
moderate or complete recovery was slightly smaller in the treated group
(22% and 36%, respectively); neither difference was statistically
significant. Volume of the supratentorial hematoma was measured from
computed tomograms in 70% of the patients in both groups and was
significantly greater in the 55 patients treated with anticoagulants than
in the 59 patients not so treated. Volume was not related to the degree of
anticoagulation. Based on the total number of patients treated with
anticoagulants in the Heerlen region, we conclude that for patients older
than 50 years of age the risk of intracerebral hemorrhage during
anticoagulant treatment is increased approximately eightfold but is
unrelated to the degree of anticoagulation. Our results suggest that
intracerebral hemorrhage is more frequent and more extensive in patients
treated with anticoagulants but that once it has occurred in such patients
intracerebral hemorrhage is not significantly more serious than in
untreated patients.
ARTICLES
Intracerebral hematomas during anticoagulant treatment
Department of Neurology, De Wever Ziekenhuis, Heerlen, The Netherlands.
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