Iatrogenic causes of an ICH: OAT therapy.
Current understanding of oral anticoagulant treatment and related intracerebral haemorrhage remains rather limited as compared to that of spontaneous intracerebral haemorrhage. Although intracerebral haemorrhage is the most serious complication of oral anticoagulant treatment, standardized treatment guidelines are still lacking. The currently employed treatments are aimed at normalization of the iatrogenic coagulation impairment, and are not based on randomized controlled trials evidence. Since most patients with oral anticoagulant treatment-intracerebral haemorrhage are at high risk of cardio-embolism and often myocardial infarction, it is uncertain whether the use of procoagulant treatments for oral anticoagulant treatment-intracerebral haemorrhage may increase their risk of thrombotic complications. Patients who receive chronic oral anticoagulant treatment urgently require effective treatments for acute oral anticoagulant treatment-intracerebral haemorrhage, and therefore controlled clinical trials are needed.
Iorio
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Università di Perugia, Sezione di Medicina Interna e Cardiovascolare, Stroke Unit, Dipartimento di Medicina Interna, Perugia, Italy. iorioa@unipg.it
D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects*; D002543:Cerebral Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology / Q000473:pathology; D002986:Clinical Trials as Topic; D015942:Factor VIIa / Q000627:therapeutic use; D006406:Hematoma; D006801:Humans; D007049:Iatrogenic Disease; D010949:Plasma; D011516:Prothrombin / Q000008:administration & dosage; D011994:Recombinant Proteins / Q000627:therapeutic use; D012306:Risk; D012307:Risk Factors; D014812:Vitamin K / Q000008:administration & dosage
D000925:Anticoagulants; D011994:Recombinant Proteins; D014812:Vitamin K; D011516:Prothrombin; C103587:recombinant FVIIa; D015942:Factor VIIa