Is coagulopathic liver disease a factor in spontaneous cerebral hemorrhage?
OBJECTIVE
Hepatic dysfunction is a common cause of thrombocytopenia and coagulopathy and has been reported as a causal factor in spontaneous intracranial hemorrhage. We attempt to define the prevalence of intracranial hemorrhage in patients with severe liver disease and coagulopathy.


METHODS
We retrospectively reviewed the medical records, CT, and MRI acquired between January 1996 and August 1999 of patients with liver disease and a coagulopathy admitted for nontraumatic acute mental status changes.


RESULTS
In 138 CT and MR scans performed on the 100 patients described above, no cases of spontaneous intracranial bleeding were detected.


CONCLUSIONS
Contrary to past reports, we find no instance of spontaneous intracranial hemorrhage in patients with coagulopathic liver disease presenting with acute mental status changes. Therefore, unless associated with trauma, spontaneous intracranial hemorrhage in coagulopathic liver disease is very uncommon.
Lee
Huey-Jen
HJ
Department of Radiology, University Hospital, University of Medicine and Dentistry of New Jersey, Newark, NJ 07103-2406, USA. leehu@umdnj.edu
Hinrichs
Clay R
CR
D000328:Adult; D000368:Aged; D001778:Blood Coagulation Disorders / Q000150:complications*; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed