Document Detail


Intracerebral hemorrhage associated with oral anticoagulant therapy: current practices and unresolved questions.
MedLine Citation:
PMID:  16339459     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Life-threatening intracranial hemorrhage, predominantly intracerebral hemorrhage (ICH), is the most serious complication of oral anticoagulant therapy (OAT), with mortality in excess of 50%. Early intervention focuses on rapid correction of coagulopathy in order to prevent continued bleeding. SUMMARY OF REVIEW: This article reviews the epidemiology of OAT-associated ICH (OAT-ICH), and current treatment options, with the aim of providing a framework for future studies of unresolved questions. A number of acute treatments are available, but all have a significant risk of inducing thrombosis and other side effects, and vary in their rapidity of effect: vitamin K (very slow response time), fresh frozen plasma (slow response time, large volume of fluid required, transfusion-related acute lung injury), prothrombin complex concentrates, and recombinant activated factor VII. Current practice is to administer a combination of vitamin K and either fresh frozen plasma or prothrombin complex concentrates; the occasional use of recombinant activated factor VII has been reported. No prospective study has addressed the efficacy of, or outcomes from, the use of these practices. CONCLUSIONS: Current management of OAT-ICH is varied and not based on evidence from randomized controlled trials. Well-designed clinical trials are essential if we are to identify the effective acute treatments for OAT-ICH that are urgently needed.
Authors:
Thorsten Steiner; Jonathan Rosand; Michael Diringer
Related Documents :
21847399 - Microglandular adenosis.
23788899 - Expression of c-kit protein in cancer vs. normal breast tissue.
22037379 - Characteristics associated with the initiation of radiation therapy after breast-conser...
22994369 - Mammaglobin 1: not only a breast-specific and tumour-specific marker, but also a hormon...
22173259 - Abducens (sixth) nerve palsy presenting as a rare case of isolated brainstem metastasis...
21713769 - Axillary lymph node failure in patients treated with accelerated partial breast irradia...
23453969 - Ikkε-mediated tumorigenesis requires k63-linked polyubiquitination by a ciap1/ciap2/tr...
7522939 - Value of prostate cancer screening in a comprehensive community cancer center.
1933809 - Dna ploidy is associated with growth potential in gastric carcinoma.
Publication Detail:
Type:  Journal Article; Review     Date:  2005-12-08
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  37     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-23     Completed Date:  2006-02-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  256-62     Citation Subset:  IM    
Affiliation:
Department of Neurology, University of Heidelberg, Germany. thorsten_steiner@med.uni-heidelberg.de
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Anticoagulants / administration & dosage,  adverse effects*
Cerebral Hemorrhage / chemically induced*,  therapy*
Clinical Trials as Topic
Factor VIIa / metabolism
Hemorrhage / chemically induced,  therapy
Humans
Recombinant Proteins / therapeutic use
Risk
Thrombosis / etiology
Vitamin K / metabolism
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Recombinant Proteins; 12001-79-5/Vitamin K; EC 3.4.21.21/Factor VIIa

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Long-term outcome after stroke: evaluating health-related quality of life using utility measurements...
Next Document:  Telemedicine-guided carotid and transcranial ultrasound: a pilot feasibility study.