title: Intracranial hemorrhages related with warfarin use and comparison of warfarin and acetylsalicylic acid.
abstract: BACKGROUND
  Acetylsalicylic acid (ASA) and warfarin are used to prevent ischemic cerebrovascular events. They have serious complications including intracranial hemorrhages (ICHs). Warfarin-related intracerebral hemorrhage (ich) incidence is .2%-5% in population that accounts for 10%-12% of all ichs. In this article, we investigated the profile of ASA and warfarin-related spontaneous ICHs in comparison with ICHs without any drug use (WADU) with their clinical, radiological, and biochemical properties.
  
  
  METHODS
  In all, 486 patients aged 18-101 years with spontaneous ICHs were included. Patients constituted 4 separate groups: users of warfarin, ASA, ASA + warfarin, and WADU. Clinical, neurological, etiological, and radiological data of these patients were compared.
  
  
  RESULTS
  There were 32 patients in warfarin, 58 patients in ASA, and 7 in warfarin + ASA group. Most of the patients were in no drug group (389 patients). The most frequent type of hemorrhage was supratentorial intraparenchymal hemorrhage. The most common accompanying disease was hypertension. The number of female patients was statistically significant in the warfarin group. Glasgow Coma Scale (GCS), accompanying diseases, opening of the hematoma to the ventricle, localization of the hemorrhage, age of the patient, and activated partial thromboplastin time level are all related to the outcome of patients. Warfarin users had worst mortality rate.
  
  
  CONCLUSIONS
  Use of warfarin, low GCS score, opening to ventricle, older age, accompanying diabetes, and/or hypertension were worse prognostic factors. It is possible that patients with these unfavorable prognostic factors cannot survive.
authors.affiliation: Department of Neurology, Atatürk Research and Training Hospital, Izmir, Turkey. Electronic address: ysecil@gmail.com.
authors.forename: Yaprak
authors.initials: Y
authors.lastname: Seçil
authors.affiliation: Department of Neurology, Atatürk Research and Training Hospital, Izmir, Turkey.
authors.forename: Yeliz
authors.initials: Y
authors.lastname: Ciftçi
authors.affiliation: Department of Neurology, Atatürk Research and Training Hospital, Izmir, Turkey.
authors.forename: Figen
authors.initials: F
authors.lastname: Tokuçoğlu
authors.affiliation: Department of Neurology, Atatürk Research and Training Hospital, Izmir, Turkey.
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Beckmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects*; D001777:Blood Coagulation / Q000187:drug effects; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects*; D015600:Glasgow Coma Scale; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D020300:Intracranial Hemorrhages / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014421:Turkey / Q000453:epidemiology; D014859:Warfarin / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D014859:Warfarin; D001241:Aspirin
keywords: ASA; Warfarin; anticoagulation; intracranial hemorrhage