title: Use of antithrombotic agents in patients with intracerebral cavernous malformations.
abstract: OBJECTIVE
  The goal of this study was to determine the risk of using antithrombotic agents in patients with established intracerebral cavernous malformations (ICMs).
  
  
  METHODS
  From a previously described cohort of 292 patients with radiographically defined ICMs, 40 required an antithrombotic after the ICM was diagnosed. Patients underwent follow-up to determine the incidence of hemorrhage.
  
  
  RESULTS
  The mean age of these 40 patients was 62.4 years; there were 21 male and 19 female patients. Five (12.5%) of the 40 patients initially presented with hemorrhage and 4 (10%) had multiple ICMs. Of these patients, 32 were placed on an antiplatelet agent alone, 6 on an anticoagulant alone, and 2 were placed on both. In patients necessitating any antithrombotic agent, 1 patient developed a prospective hemorrhage over the 258 person-years of follow-up (prospective hemorrhage rate 0.41% per person-year).
  
  
  CONCLUSIONS
  Antithrombotics likely do not precipitate hemorrhage in patients with known ICMs. However, caution should be exercised in the use of antithrombotics in patients with ICMs at high risk for hemorrhage. The risks and benefits of antithrombotics in each situation should be carefully weighed against the natural history of ICM.
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota 55905, USA. flemming.kelly@mayo.edu
authors.forename: Kelly D
authors.initials: KD
authors.lastname: Flemming
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Link
authors.forename: Teresa J H
authors.initials: TJ
authors.lastname: Christianson
authors.forename: Robert D
authors.initials: RD
authors.lastname: Brown
mesh_terms: D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D002543:Cerebral Hemorrhage / Q000209:etiology*; D004176:Dipyridamole / Q000627:therapeutic use; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D020786:Hemangioma, Cavernous, Central Nervous System / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D014859:Warfarin; D004176:Dipyridamole; D001241:Aspirin