Intracranial Hematoma in Patients Receiving Warfarin – Case Reports and Recommended Therapy

Czech version

Authors: V. Přibáň ^1,2; M. Holý ³; I. Vonke ⁴
Authors‘ workplace: Neurochirurgické oddělení, Nemocnice České Budějovice, a. s. ¹; Neurochirurgická klinika LF MU a FN Brno ²; Interní oddělení, Nemocnice České Budějovice, a. s. ³; Hematologické oddělení, Nemocnice České Budějovice, a. s. ⁴
Published in: Cesk Slov Neurol N 2009; 72/105(6): 570-574
Category: Case Report

Overview

Intracranial haemorrhage, whether spontaneous or the result of trauma, involves high morbidity// mortality. Older patients with medical co- morbidities often suffer from these haematomas. The authors present three case reports of intracranial haemorrhages (two of traumatic origin and one spontaneous) which involved a non‑standard approach to reversal therapy. They stress the need for rapid warfarin reversal and propose a therapeutic protocol that consists of rapid substitution of clotting factors together with urgent surgical intervention if indicated. Further, patients on oral anticoagulant therapy with intracranial haematoma should always be admitted in the centres with permanent neurosurgical services. Rapid warfarin reversal together with emergency operation in the event of clinical deterioration are conditions for the improvement of results in the treatment of intracranial haemorrhage in oral anticoagulant therapy patients.

Key words:
intracranial hemorrhage – warfarin – surgery

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