Management of oral anticoagulant-induced intracranial haemorrhage

Butler, A.C. and Tait, R.C. (1998) Management of oral anticoagulant-induced intracranial haemorrhage. Blood Reviews, 12(1), pp. 35-44. (doi: 10.1016/S0268-960X(98)90028-5) (PMID:9597196)

Abstract

Intracranial haemorrhage is an infrequent but often fatal complication of oral anticoagulant therapy which will become more common as anticoagulant use increases. The risk of anticoagulant-induced intracranial haemorrhage may be reduced by judicious prescribing, identification of patients at high risk of bleeding, and close monitoring by experienced staff. The presenting features of intracranial haemorrhage are often vague and physicians should be aware of the need for urgent investigation of all anticoagulated patients with neurological symptoms. Current guidelines for immediate reversal of anticoagulation recommend administration of vitamin K1 and factor replacement with either factor concentrates or fresh frozen plasma. In this review we discuss recent evidence suggesting prothrombin complex concentrates lead to faster, and more complete, correction of coagulation and, in the context of intracranial bleeding, may be associated with improved neurological status. Evidence for the risks of short-term cessation of anticoagulants, in the immediate period following an intracranial haemorrhage, and their subsequent reintroduction is also discussed.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Tait, Dr Robert
• Authors: Butler, A.C., and Tait, R.C.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Blood Reviews
• Publisher: Harcourt Brace & Company
• ISSN: 0268-960X
• ISSN (Online): 1532-1681