Original Paper

Intracranial Hemorrhage and Oral Anticoagulant Treatment
J.-Ph. Neau^a, C. Couderq^a, P. Ingrand^b, P. Blanchon^c, R. Gil^a, and the VGP Study Group

^aDepartment of Neurology, CHU La Milétrie,
^bDepartment of Biostatistics, Faculté de Médicine et Pharmacie,
^cGeneral Practitioner, VGP Study Group, Poitiers, France

Address of Corresponding Author

Cerebrovasc Dis 2001;11:195-200 (DOI: 10.1159/000047638)

  Key Words

• Oral anticoagulation
• Intracranial hemorrhage
• Risk factors

  Abstract

Objective: To detect risk factors for intracranial hemorrhage (ICH) in patients with long-term oral anticoagulant and to identify clinical or radiological data specific of anticoagulant-related ICH. Methods and Patients: Three groups of patients were included. Group 1 represents patients who were admitted because of anticoagulant-related ICH between January 1984 and February 1996. All patients underwent CT scan. Clinical data, anticoagulation parameters, location and volume of the ICH, treatment and the 30-days in-hospital mortality were analyzed. Group 2 consisted of patients selected at random among all patients with spontaneous ICH admitted to our department during the same period of time. Patients without ICH, but regularly taking oral anticoagulants constituted group 3. Results: Seventy-nine patients with anticoagulant-related ICH were compared to 127 patients with spontaneous ICH. The volume of supratentorial ICH was greater in group 1 of patients and was correlated with a worse prognosis. Comparison of group 1 with group 3 (212 controls) demonstrated that length of anticoagulation, prothrombin time or excessive anticoagulation, prior cerebral infarct and use of acénocoumarol, but not age or indication of anticoagulant, were significant risk factors for ICH in multivariate analysis. Conclusions: The results emphasize that anticoagulant-related ICH are not clinically different from spontaneous ICH except for volume of bleeding, and that frequent and careful coagulation monitoring is needed, especially during the first year in order to decrease the risk of ICH.

Copyright © 2001 S. Karger AG, Basel

  Author Contacts

Jean-Philippe Neau
University Department of Neurology, CHU La Milétrie
F-86021 Poitiers Cedex (France)
Tel. +33 05 49 44 44 46, Fax +33 05 49 44 38 56
E-Mail jph.neau@chu-poitiers.fr

  Article Information

Received: Received: January 22, 2000
Accepted: August 31, 2000
Number of Print Pages : 6
Number of Figures : 0, Number of Tables : 2, Number of References : 33