Document Detail


Warfarin-associated intraventricular hemorrhage.
MedLine Citation:
PMID:  18173903     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: In this study, we have reviewed our experience with anticoagulation-associated intraventricular hemorrhage (IVH). Our goal was to determine if IVH is also an independent prognosticator of fatal outcome in patients with anticoagulation-associated intracerebral hemorrhage (ICH). METHODS: This study is a retrospective analysis of medical records and computed tomographic imaging. Eighty-eight patients with warfarin-associated ICH were analysed, including eight patients with predominant IVH. RESULTS: There was a very low rate of hemorrhage extension in patients with predominant IVH. Despite that, those patients had 50% 30 day mortality. Overall patients with ICH had 45% 30 day mortality. Ventricular extension raised mortality in ICH patients to 75%, while the absence of ventricular extension carried only 23% 30 day mortality. IVH was significantly associated with 30 day mortality (p<0.001). Panventricular extension was uniformly fatal in patients with ICH and carried 75% 30 day mortality in patients with predominant IVH. On a multivariate logistic regression model including age, ICH volume and IVH, ICH volume (p<0.001) and IVH (p = 0.003) remained independently associated with early mortality. CONCLUSION: Extension of anticoagulation-associated ICH into ventricular system caused a high mortality, especially in patients with panventricular involvement. IVH is an independent predictor of early death in these patients. In our experience, the majority of IVH do not expand over time and poor outcome appears to be related to the magnitude of the initial insult.
Authors:
Alexander Zubkov; Daniel O Claassen; Alejandro A Rabinstein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurological research     Volume:  29     ISSN:  0161-6412     ISO Abbreviation:  Neurol. Res.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2008-01-04     Completed Date:  2008-02-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7905298     Medline TA:  Neurol Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  661-3     Citation Subset:  IM    
Affiliation:
Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Anticoagulants / adverse effects*
Brain / blood supply,  pathology,  physiopathology
Cerebral Arteries / drug effects,  pathology,  physiopathology
Cerebral Hemorrhage / chemically induced*,  mortality*
Choroid Plexus / drug effects,  physiopathology
Female
Hospital Mortality / trends
Humans
Lateral Ventricles / blood supply,  physiopathology*,  radiography
Male
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Factors
Tomography, X-Ray Computed
Warfarin / adverse effects*
Chemical
Reg. No./Substance:
0/Anticoagulants; 81-81-2/Warfarin

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


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