Intracranial hemorrhage and oral anticoagulant treatment.
OBJECTIVE
To detect risk factors for intracranial hemorrhage (ICH) in patients with long-term oral anticoagulant and to identify clinical or radiological data specific of anticoagulant-related ICH.


METHODS
Three groups of patients were included. Group 1 represents patients who were admitted because of anticoagulant-related ICH between January 1984 and February 1996. All patients underwent CT scan. Clinical data, anticoagulation parameters, location and volume of the ICH, treatment and the 30-days in-hospital mortality were analyzed. Group 2 consisted of patients selected at random among all patients with spontaneous ICH admitted to our department during the same period of time. Patients without ICH, but regularly taking oral anticoagulants constituted group 3.


RESULTS
Seventy-nine patients with anticoagulant-related ICH were compared to 127 patients with spontaneous ICH. The volume of supratentorial ICH was greater in group 1 of patients and was correlated with a worse prognosis. Comparison of group 1 with group 3 (212 controls) demonstrated that length of anticoagulation, prothrombin time or excessive anticoagulation, prior cerebral infarct and use of acénocoumarol, but not age or indication of anticoagulant, were significant risk factors for ICH in multivariate analysis.


CONCLUSIONS
The results emphasize that anticoagulant-related ICH are not clinically different from spontaneous ICH except for volume of bleeding, and that frequent and careful coagulation monitoring is needed, especially during the first year in order to decrease the risk of ICH.
Neau
J P
JP
Department of Neurology, CHU La Milétrie, Poitiers, France.
Couderq
C
C
Ingrand
P
P
Blanchon
P
P
Gil
R
R
D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000453:epidemiology; D002544:Cerebral Infarction / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005602:France / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D020300:Intracranial Hemorrhages / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
D000925:Anticoagulants