title: Antithrombotic therapy and predilection for cerebellar hemorrhage.
abstract: BACKGROUND
  With the recent increase in the use of antithrombotic therapy, intracerebral hemorrhage (ICH) has been found to be a common complication. We determined whether the use of oral antithrombotic therapy and the patients' preexisting comorbidities were predictive of cerebellar hemorrhage (CH; previously reported to be associated with anticoagulants) as compared to other ICH, and whether antithrombotic therapy affected the clinical severity of CH.
  
  
  METHODS
  A study of 327 consecutive patients hospitalized in our institute within 3 days after the onset of ICH, including 38 patients with a CH.
  
  
  RESULTS
  CH accounted for 12% of all ICH, 75% of which occurred in patients on warfarin therapy with an international normalized ratio (INR) for prothrombin time >2.5 (p < 0.0001), and 33% of which occurred in patients on ticlopidine therapy (p = 0.017). Warfarin therapy with an INR >2.5 and high blood glucose on admission were independently predictive of CH as compared to other ICH. In addition, previous ischemic stroke (p = 0.002) and heart diseases (p = 0.018) were more prevalent in patients with CH than in those with other ICH. The number of major arteriosclerotic comorbidities and risk factors was also independently predictive of CH risk.
  
  
  CONCLUSIONS
  We confirmed that warfarin therapy with an INR >2.5 is associated with CH. Patients with CH frequently had arteriosclerotic comorbidities requiring antithrombotic therapy that can complicate their acute management.
authors.affiliation: Department of Cerebrovascular Disease, Cerebrovascular Center and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. toyoda@hsp.ncvc.go.jp
authors.forename: Kazunori
authors.initials: K
authors.lastname: Toyoda
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Okada
authors.forename: Setsuro
authors.initials: S
authors.lastname: Ibayashi
authors.forename: Tooru
authors.initials: T
authors.lastname: Inoue
authors.forename: Kotaro
authors.initials: K
authors.lastname: Yasumori
authors.forename: Daisuke
authors.initials: D
authors.lastname: Fukui
authors.forename: Takeshi
authors.initials: T
authors.lastname: Uwatoko
authors.forename: Noriko
authors.initials: N
authors.lastname: Makihara
authors.forename: Kazuo
authors.initials: K
authors.lastname: Minematsu
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D001161:Arteriosclerosis / Q000150:complications; D001241:Aspirin / Q000009:adverse effects; D001786:Blood Glucose; D002526:Cerebellar Diseases / Q000139:chemically induced*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D020300:Intracranial Hemorrhages / Q000139:chemically induced*; D007564:Japan; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000150:complications; D013988:Ticlopidine / Q000009:adverse effects; D013997:Time Factors; D014859:Warfarin / Q000009:adverse effects
chemical_list: D000925:Anticoagulants; D001786:Blood Glucose; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin; D013988:Ticlopidine; D001241:Aspirin