Authors: Freeman, William D; Aguilar, Maria I

Source: Expert Review of Neurotherapeutics, Volume 8, Number 2, February 2008 , pp. 271-290(20)

Publisher: Expert Reviews

Abstract:

Warfarin-related intracerebral hemorrhage (WICH) is a medical and neurosurgical emergency with a 1-month mortality of approximately 50%. Warfarin is commonly is used in patients with atrial fibrillation to prevent ischemic stroke and to prevent progression of deep vein thrombosis to pulmonary embolism. Owing to the ageing population, and increased incidence of atrial fibrillation with age and warfarin use, the incidence of WICH is expected to rise in the future. When WICH occurs, immediate discontinuation of warfarin with rapid warfarin reversal remains the first-line intervention, often with neurosurgical intervention. The optimal agent for rapid warfarin anticoagulation reversal remains to be defined owing to the lack of prospective randomized trials. We review current literature and prospects for future research for this devastating neurologic emergency.

Keywords: hemorrhage; intracerebral; management; treatment; warfarin

Document Type: Research article

DOI: http://dx.doi.org/10.1586/14737175.8.2.271

Affiliations: 1: Mayo Clinic Jacksonville, Department of Neurology, Cannaday 2 East, Jacksonville, FL 32224, USA., Email: freeman.william1@mayo.edu

Publication date: 2008-02-01

More about this publication?

• Expert Review of Neurotherapeutics provides expert commentary on the use of drugs and medicines in clinical neurology and neuropsychiatry. Coverage includes disease management, new medicines and drugs in neurology, therapeutic indications, diagnostics, medical treatment guidelines and neurological diseases such as stroke, epilepsy, Alzheimer's and Parkinson's.
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