Spontaneous intracerebral hemorrhage with antiplatelets/anticoagulants/none: a comparison analysis.
BACKGROUND
Problems that the risk of using antiplatelet/anticoagulant may overwhelm its benefits have been raised. We analyzed patients with spontaneous intracerebral hemorrhage who had received antiplatelet/anticoagulant therapy.


METHODS
A consecutive series of patients with spontaneous intracerebral hemorrhage who underwent brain computed tomographic (CT) scans within 48 h from attack. We analyzed the clinical manifestations and radiologic findings of the patients according to antiplatelet/anticoagulant therapy: Antiplatelet group, Anticoagulant group, and None group.


RESULTS
A total of 338 patients were included in the study. The initial volume of hematoma was 46.8 ml in the Anticoagulant group, and 24.1 ml in the None group. There were significant differences among the groups in terms of intraventricular hemorrhage (Antiplatelet group: 45.6 %, Anticoagulant group: 20 %, None: 26.4 %, p = 0.008), and the proportion of hydrocephalus in the Antiplatelet group was higher than in another group (p = 0.017). Also, herniation and expansion of spontaneous intracerebral hemorrhage had significant differences among the groups. The prognoses of the None group were the best among the groups. There was also significant difference in the mortality among the groups.


CONCLUSIONS
In comparison with the None group, the spontaneous intracerebral hemorrhages of the Antiplatelet/Anticoagulant group were a little more extensive and they had more intraventricular hemorrhage, hydrocephalus, herniation, and expansion of spontaneous intracerebral hemorrhage that would come to poor prognosis. Therefore, antiplatelets and anticoagulants should be used under strict indications.
Department of Neurosurgery, Ewha Womans University School of Medicine, Mokdong Hospital, 911-1 Mok-dong, Yangcheon-gu, Seoul, 158-710, Korea.
Na Rae
NR
Yang
Sang Jin
SJ
Kim
Eui Kyo
EK
Seo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012422:Rupture, Spontaneous / Q000000981:diagnostic imaging / Q000453:epidemiology*; D020521:Stroke / Q000517:prevention & control; D014057:Tomography, X-Ray Computed; D055815:Young Adult
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors