Antithrombotic therapy and predilection for cerebellar hemorrhage.

Abstract

BACKGROUND:

With the recent increase in the use of antithrombotic therapy, intracerebral hemorrhage (ICH) has been found to be a common complication. We determined whether the use of oral antithrombotic therapy and the patients' preexisting comorbidities were predictive of cerebellar hemorrhage (CH; previously reported to be associated with anticoagulants) as compared to other ICH, and whether antithrombotic therapy affected the clinical severity of CH.

METHODS:

A study of 327 consecutive patients hospitalized in our institute within 3 days after the onset of ICH, including 38 patients with a CH.

RESULTS:

CH accounted for 12% of all ICH, 75% of which occurred in patients on warfarin therapy with an international normalized ratio (INR) for prothrombin time >2.5 (p < 0.0001), and 33% of which occurred in patients on ticlopidine therapy (p = 0.017). Warfarin therapy with an INR >2.5 and high blood glucose on admission were independently predictive of CH as compared to other ICH. In addition, previous ischemic stroke (p = 0.002) and heart diseases (p = 0.018) were more prevalent in patients with CH than in those with other ICH. The number of major arteriosclerotic comorbidities and risk factors was also independently predictive of CH risk.

CONCLUSIONS:

We confirmed that warfarin therapy with an INR >2.5 is associated with CH. Patients with CH frequently had arteriosclerotic comorbidities requiring antithrombotic therapy that can complicate their acute management.

• Authors: Kazunori Toyoda, Yasushi Okada, Setsuro Ibayashi, Tooru Inoue, Kotaro Yasumori, Daisuke Fukui, Takeshi Uwatoko, Noriko Makihara, Kazuo Minematsu
• Journal: Cerebrovascular diseases (Basel, Switzerland) (Cerebrovasc Dis) Vol. 23 Issue 2-3 Pg. 109-16 ( 2007) ISSN: 1015-9770 [Print] Switzerland
• PMID: 17124390 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anticoagulants
• Blood Glucose
• Fibrinolytic Agents
• Platelet Aggregation Inhibitors
• Warfarin
• Ticlopidine
• Aspirin

Topics

• Administration, Oral
• Adult
• Aged
• Aged, 80 and over
• Anticoagulants (administration & dosage, adverse effects)
• Arteriosclerosis (complications)
• Aspirin (adverse effects)
• Blood Glucose
• Cerebellar Diseases (chemically induced)
• Female
• Fibrinolytic Agents (administration & dosage, adverse effects)
• Heart Diseases (complications)
• Humans
• Intracranial Hemorrhages (chemically induced)
• Japan
• Male
• Middle Aged
• Odds Ratio
• Platelet Aggregation Inhibitors (administration & dosage, adverse effects)
• Predictive Value of Tests
• Prospective Studies
• Registries
• Risk Assessment
• Risk Factors
• Stroke (complications)
• Ticlopidine (adverse effects)
• Time Factors
• Warfarin (adverse effects)