title: [Intracranial hemorrhage in adults: place of antithrombotic treatment].
abstract: OBJECTIVE
  Antithrombotic (anticoagulants and antiplatelets) are responsible for iatrogenic accidents, with a specific impact in neurosurgery. Bleeding complications are the most common and best-known. But the link to antiplatelet or to dual association of antithrombotic treatment with intracranial haemorrhage is not complete yet. We studied the proportion of patients under antithrombotic treatment, when an intracranial hemorrhage occurred, as well as the morbi-mortality of each group of patients (with or without antithrombotic treatment). Finally, we studied the proportion of off-label prescriptions.
  
  
  METHODS
  We conducted a monocentric and comprehensive prospective study on a group of patients. All patients that had been admitted for intracranial hemorrhage to our hospital, in a 5-month period were included in the study.
  
  
  RESULTS
  One hundred and sixty patients admitted for an intracranial hemorrhage were included during 70days of call. Seventy-four of these patients (46.25%) were under antithrombotic treatment: 40 under antiplatelet treatment (54%), 29 under anticoagulant treatment (39.2%), four under dual antithrombotic treatment (5.4%), and one under Arixtra(®). Half of the patients under antithrombotic treatment had poor prognosis as compared to 40% of patients without antithrombotic treatment. Off-label antithrombotic therapy was estimated at 27.3% of all prescriptions.
  
  
  CONCLUSIONS
  The prevalence of antithrombotic therapy in patients is high when intracranial hemorrhage occurs. Some complications could be avoided by decreasing the number of off-label prescriptions and by better controlling their use (using standardized INR). Antiplatelet treatments and new antithrombotic therapies require better drug monitoring which could be part of the establishment of a specific register.
authors: Service de neurochirurgie A, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
authors: L
authors: L
authors: Carlucci
authors: M
authors: M
authors: De Pomerol
authors: D
authors: D
authors: Laguerre
authors: E
authors: E
authors: Gimbert
authors: M
authors: M
authors: Dautheribes
authors: F
authors: F
authors: San-Galli
authors: D
authors: D
authors: Liguoro
authors: M
authors: M
authors: Le-Gall
authors: J-R
authors: JR
authors: Vignes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D016903:Drug Monitoring; D004357:Drug Synergism; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D020300:Intracranial Hemorrhages / Q000139:chemically induced* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D056687:Off-Label Use / Q000706:statistics & numerical data; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors