Management of anticoagulation following central nervous system hemorrhage in patients with high thromboembolic risk

Journal of Thrombosis and Haemostasis

Volumn 8, Issue 7, 2010, Pages 1500-1508

  Hawryluk, G W J ^a,b,c   Austin, J W ^a,b   Furlan, J C ^a,c,d   Lee, J B ^a   O'Kelly, C ^e   Fehlings, M G ^a,b,c,f  

^a UNIVERSITY HEALTH NETWORK   (Canada)

^b Institute of Medical Science   (Canada)

^c UNIVERSITY OF TORONTO   (Canada)

^d UNIVERSITY OF TORONTO   (Canada)

^e UNIVERSITY OF ALBERTA   (Canada)

^f UNIVERSITY HEALTH NETWORK   (Canada)

Author keywords

Anticoagulation; Central nervous system; Complications; Hemorrhage; Optimization; Thrombosis

Indexed keywords

ANTICOAGULATION; ARTICLE; BRAIN HEMORRHAGE; CENTRAL NERVOUS SYSTEM; CENTRAL NERVOUS SYSTEM DISEASE; CLINICAL FEATURE; CONTROLLED STUDY; HUMAN; INJURY; MAJOR CLINICAL STUDY; MEDICAL DECISION MAKING; PRIORITY JOURNAL; RISK FACTOR; SUBDURAL HEMATOMA; THROMBOEMBOLISM;

ANTICOAGULANTS; CENTRAL NERVOUS SYSTEM; DISEASE MANAGEMENT; HEMORRHAGE; HUMANS; INTRACRANIAL HEMORRHAGES; RISK; THROMBOEMBOLISM; TIME FACTORS;

EID: 77955020924     PISSN: 15387933     EISSN: 15387836     Source Type: Journal    
DOI: 10.1111/j.1538-7836.2010.03882.x     Document Type: Article

References (76)

1. Phillips B, Ball C, Sackett D, Badenoch D, Straus S, Haynes B, Howick J, Dawes M. Oxford centre for evidence-based medicine - levels of evidence. http://www.cebm.net/index.aspx?o=1025, Oxford Centre for Evidence-based Medicine; 2009. Accessible at:
2. Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health 1998, 52:377-84.
3. Phan TG, Koh M, Wijdicks EF. Safety of discontinuation of anticoagulation in patients with intracranial hemorrhage at high thromboembolic risk. Arch Neurol 2000, 57:1710-3.
4. Wijdicks EF, Schievink WI, Brown RD, Mullany CJ. The dilemma of discontinuation of anticoagulation therapy for patients with intracranial hemorrhage and mechanical heart valves. Neurosurgery 1998, 42:769-73.
5. Kase CS, Robinson RK, Stein RW, DeWitt LD, Hier DB, Harp DL, Williams JP, Caplan LR, Mohr JP. Anticoagulant-related intracerebral hemorrhage. Neurology 1985, 35:943-8.
6. Lieberman A, Hass WK, Pinto R, Isom WO, Kupersmith M, Bear G, Chase R. Intracranial hemorrhage and infarction in anticoagulated patients with prosthetic heart valves. Stroke 1978, 9:18-24.
7. Babikian VL, Kase CS, Pessin MS, Caplan LR, Gorelick PB. Resumption of anticoagulation after intracranial bleeding in patients with prosthetic heart valves. Stroke 1988, 19:407-8.
8. Wong JB, Webb RK, Pauker SG. Double trouble: a patient with two prosthetic valves and two episodes of intracranial bleeding. Med Decis Making 1987, 7:174-93.
9. Bertram M, Bonsanto M, Hacke W, Schwab S. Managing the therapeutic dilemma: patients with spontaneous intracerebral hemorrhage and urgent need for anticoagulation. J Neurol 2000, 247:209-14.
10. Lau CP, Chang CM, Lau GK, Wong CK, Fong PC, Yu YL. Cerebral haemorrhage in anticoagulated patients with non-septic mechanical valvular prosthesis. Int J Cardiol 1991, 30:289-96.
11. Crawley F, Bevan D, Wren D. Management of intracranial bleeding associated with anticoagulation: balancing the risk of further bleeding against thromboembolism from prosthetic heart valves. J Neurol Neurosurg Psychiatry 2000, 69:396-8.
12. Gomez CR, Sandhu J, Mehta P. Resumption of anticoagulation during hypertensive cerebral hemorrhage with prosthetic heart valve. Stroke 1988, 19:407.
13. Lagares A, Dominguez J, Lobato RD, Gonzalez P. Bilateral posterior fossa subdural haematomas secondary to anticoagulant therapy. Acta Neurochir 1998, 140:1097-8.
14. Leker RR, Abramsky O. Early anticoagulation in patients with prosthetic heart valves and intracerebral hematoma. Neurology 1998, 50:1489-91.
15. Maingi M, Glynn MF, Scully HE, Graham AF, Floras JS. Spontaneous spinal epidural hematoma in a patient with a mechanical aortic valve taking warfarin. Can J Cardiol 1995, 11:429-32.
16. Toledo E, Shalit MN, Segal R. Spinal subdural hematoma associated with anticoagulant therapy in a patient with spinal meningioma. Neurosurgery 1981, 8:600-3.
17. Nagano N, Tabata H, Hashimoto K. Anticoagulant-related intracerebral hemorrhage in patients with prosthetic heart valves--report of two cases. Neurol Med Chir (Tokyo) 1991, 31:743-5.
18. Nakagawa T, Kubota T, Handa Y, Kawano H, Sato K. Intracranial hemorrhage due to long-term anticoagulant therapy in patients with prosthetic heart valves--four case reports. Neurol Med Chir (Tokyo) 1995, 35:156-9.
19. Ananthasubramaniam K, Beattie JN, Rosman HS, Jayam V, Borzak S. How safely and for how long can warfarin therapy be withheld in prosthetic heart valve patients hospitalized with a major hemorrhage? Chest 2001, 119:478-84.
20. Motomochi M, Makita Y, Nabeshima S, Itagaki T, Tei T. Spinal subarachnoid hemorrhage due to a thoracic neurinoma during anticoagulation therapy. A case report. Neurol Med Chir (Tokyo) 1981, 21:781-4.
21. Gabl M, Kostron H. Acute spinal subdural haematoma. Neurochirurgia (Stuttg) 1988, 31:99-100.
22. Badaoui R, Koukougnon M, El kettani C, Ouendo M, Rekik R, Tchaoussoff J. Spontaneous spinal hemorrhage complicating anticoagulant therapy. Can J Anaesth 2003, 50:750-1.
23. Maeda K, Shimbo T, Fukui T. Cost-effectiveness of a community-based screening programme for chronic atrial fibrillation in Japan. J Med Screen 2004, 11:97-102.
24. Hurst PG, Seeger J, Carter P, Marcus FI. Value of magnetic resonance imaging for diagnosis of cervical epidural hematoma associated with anticoagulation after cardiac valve replacement. Am J Cardiol 1989, 63:1016-7.
25. Miller DR, Ray A, Hourihan MD. Spinal subdural haematoma: how relevant is the INR? Spinal Cord 2004, 42:477-80.
26. Shah N, Dawson SL. Intracerebral haemorrhage, prosthetic heart valve and anticoagulation. J R Soc Med 2004, 97:129-30.
27. Wani M, Nga E, Navaratnasingham R. Evidence based case report: should a patient with primary intracerebral haemorrhage receive antiplatelet or anticoagulant therapy? Br Med J 2005, 331:439-42.
28. Park S, Kase CS. Re-anticoagulation after warfarin-related intracerebral hemorrhage in patients with mechanical heart valves: the clinical dilemma. Seminars in Cerebrovascular Diseases & Stroke 2006, 5:221-4.
29. Zingale A, Chibbaro S, Florio A, Distefano G, Porcaro S. Management of chronic subdural hematoma in patients treated with anticoagulation. J Neurosurg Sci 1999, 43:277-84.
30. Saab M, Gray A, Hodgkinson D, Irfan M. Warfarin and the apparent minor head injury. J Accid Emerg Med 1996, 13:208-9.
31. Sharma N, Grover A, Radotra BD. Prosthetic cardiac valve replacement: management problems. Asian Cardiovasc Thorac Ann 1998, 6:179-82.
32. Sharma SN, Iyengar SS, Nandi B. Prosthetic heart valve, antiocoagulants and cerebral hemorrhage. J Assoc Physicians India 1994, 42:581.
33. Barbero F, Pengo V, Fasoli G. Fatal cerebral hemorrhage complicating thromboembolic stroke in a patient with prosthetic mitral valve thrombosis treated with thrombolytic therapy. Clin Appl Thromb Hemost 1997, 3:290-3.
34. Bayir A, Akilli B, Cengiz SL. Spinal epidural haematoma related to oral anticoagulant overdose. A case report. Neuroradiology Journal 2008, 21:368-70.
35. Kapisiz NS, Kapisiz F, Dogan OV, Toker M, Yucel E. Management of intracranial bleeding in patients with mechanical heart valves: three case reports and a study of the literature. Trakya Universitesi Tip Fakultesi Dergisi 2007, 24:169-74.
36. Petrasko MS, Sadaniantz A. Bleeding and thrombotic risks for prosthetic heart valves: a review of the principles of management. Cardiovasc Rev Rep 2000, 21:475-80.
37. Phuong LK, Wijdicks EFM, Sanan A. Spinal epidural hematoma and high thromboembolic risk: between Scylla and Charybdis. Mayo Clin Proc 1999, 74:147-9.
38. McClaskey EM, Michalets EL. Subdural hematoma after a fall in an elderly patient taking high-dose omega-3 fatty acids with warfarin and aspirin: case report and review of the literature. Pharmacotherapy 2007, 27:152-60.
39. Pichler W, Seibert FJ, Hartwagner W, Grechenig W, Kopeinigg G. Air bag and oral anticoagulation: a deadly combination in a low-velocity car accident. Am J Emerg Med 2008, 26:e3-5.
40. Ratnaweera M, Janowski W, Simmons D. Multiple thrombotic events following warfarin reversal. Intern Med J 2007, 37:580-1.
41. Whedon JM, Quebada PB, Roberts DW, Radwan TA. Spinal epidural hematoma after spinal manipulative therapy in a patient undergoing anticoagulant therapy: a case report. J Manipulative Physiol Ther 2006, 29:582-5.
42. Romero JR, Sakai O, Rice MB, Babikian VL. Intracranial hemorrhage sparing meningioma in an anticoagulated patient. J Neuroimaging 2007, 17:246-50.
43. Kanoff R, Ruberg R. Bilateral spontaneous intracerebral hematomas following anticoagulation therapy: report of a case with recovery following surgery. J Am Osteopath Assoc 1979, 79:174-8.
44. Zuccarello M, Scararini M, D'Avella D, Andrioli GC, Gerosa M. Spontaneous spinal extradural hematoma during anticoagulant therapy. Surg Neurol 1980, 14:411-3.
45. Everett BA, Kusske JA, Pribram HW. Anticoagulants and intracerebral hemorrhage from an unsuspected meningioma. Surg Neurol 1979, 11:233-5.
46. Domenicucci M, Ramieri A, Ciappetta P, Delfini R. Nontraumatic acute spinal subdural hematoma. J Neurosurg Spine 1999, 91:65-73.
47. Aoyagi S, Kosuga T, Fukunaga S, Tayama E, Ueda T. Subdural hematoma after open-heart surgery. J Heart Valve Dis 2007, 16:450-3.
48. Kanter R, Kanter M, Kirsch W, Rosenberg G. Spontaneous posterior fossa subdural hematoma as a complication of anticoagulation. Neurosurgery 1984, 15:241-2.
49. Cakirer S, Basak M, Galip GM. Cervical hematomyelia secondary to oral anticoagulant therapy: case report. Neuroradiology 2001, 43:1087-8.
50. Butler AC, Tait RC. Restarting anticoagulation in prosthetic heart valve patients after intracranial haemorrhage: a 2-year follow-up. Br J Haematol 1998, 103:1064-6.
51. Kawamata T, Takeshita M, Kubo O, Izawa M, Kagawa M, Takakura K. Management of intracranial hemorrhage associated with anticoagulant therapy. Surg Neurol 1995, 44:438-42. Discussion 443
52. De Vleeschouwer S, Van Calenbergh F, van Loon J, Nuttin B, Goffin J, Plets C. Risk analysis of thrombo-embolic and recurrent bleeding events in the management of intracranial haemorrhage due to oral anticoagulation. Acta Chir Belg 2005, 105:268-74.
53. Forsting M, Mattle HP, Huber P. Anticoagulation-related intracerebral hemorrhage. Cerebrovasc Dis 1991, 1:97-102.
54. Barra JA, Kretz JG, Grondin P. Sub-dural hematoma, complication of anti-coagulants for valvular mechanical protheses. Role of heterografts. Ann Cardiol Angeiol (Paris) 1979, 28:163-5.
55. Asai Y, Sugiki K, Abe T, Komatsu S, Inoue Y. Surgical experience of subacute subdural hematoma occurring during the anticoagulant therapy. Rinsho Kyobu Geka 1984, 4:87-91.
56. Nobuoka W, Konishi M, Asazuma S, Iwamoto T, Hamashima T. A case of chronic subdural hematoma developing during long-term anticoagulant drug therapy after mitral valve replacement. Rinsho Kyobu Geka 1984, 4:603-5.
57. Cruz JV, Marti-Vilalta C, Tordesillas L. Anticoagulacion en el infarto cerebral de origen cardiaco. Estudio de 58 pacientes durante la fase aguda. Neurologia 1986, 2:57-62.
58. Toyonaga M, Hagiwara N, Irie F, Toyoda K, Fujimoto S, Hitotsumatsu T, Okada Y. Acute cervical spinal epidural hematoma during antithrombotic therapy: dual warnings against antithrombotic therapy. Rinsho Shinkeigaku 2003, 43:287-90.
59. Oka K, Kamota T, Satou M, Murakami M, Kobayashi T, Shirasawa B, Mikamo A, Hamano K. Subdural hematoma following cardiac surgery. Kyobu Geka 2008, 61:868-72.
60. Kirazli Y, Akkoc Y, Kanyilmaz S. Spinal epidural hematoma associated with oral anticoagulation therapy. Am J Phys Med Rehabil 2004, 83:220-3.
61. Riaz S, Jiang H, Fox R, Lavoie M, Mahood JK. Spontaneous spinal epidural hematoma causing Brown-Sequard syndrome: case report and review of the literature. J Emerg Med 2007, 33:241-4.
62. Pal D, Gnanalingham K, Peterson D. A case of spontaenous acute subdural haematoma in the posterior fossa following anticoagulation. Br J Neurosurg 2004, 18:68-9.
63. Vaya A, Resureccion M, Ricart JM, Ortuno C, Ripoll F, Mira Y, Aznar J. Spontaneous cervical epidural hematoma associated with anticoagulant therapy. Clin Appl Thromb Hemost 2001, 7:166-8.
64. Guthikonda M, Schmidek HH, Wallman LJ, Snyder TM. Spinal subdural hematoma: case report and review of the literature. Neurosurgery 1979, 5:614-6.
65. Olson S, Rossato R, Guazzo E. Acute subdural hematomas and enoxaparin. J Clin Neurosci 2002, 9:256-9.
66. Khan S, Al-Qahtani M. Mandatory anticoagulation despite a cerebellar hematoma. Neurosciences 2004, 9:120.
67. Vongpatanasin W, Hillis LD, Lange RA. Prosthetic heart valves. N Engl J Med 1996, 335:407-16.
68. Wijdicks EF, Schievink WI, Brown RD, Mullany CY. Early anticoagulation in patients with prosthetic heart valves and intracerebral hematoma. Neurology 1999, 52:676-7.
69. Diamond T, Gray WJ, Chee CP, Fannin TF. Subdural haematoma associated with long term oral anticoagulation. Br J Neurosurg 1988, 2:351-6.
70. Romualdi E, Micieli E, Ageno W, Squizzato A. Oral anticoagulant therapy in patients with mechanical heart valve and intracranial haemorrhage. A systematic review. Thromb Haemost 2009, 101:290-7.
71. Hirsh J, Dalen J, Anderson DR, Poller L, Bussey H, Ansell J, Deykin D. Oral anticoagulants: mechanism of action, clinical effectiveness, and optimal therapeutic range. Chest 2001, 119(Suppl. 1):8S-21S.
72. Hylek EM, Go AS, Chang Y, Jensvold NG, Henault LE, Selby JV, Singer DE. Effect of intensity of oral anticoagulation on stroke severity and mortality in atrial fibrillation. N Engl J Med 2003, 349:1019-26.
73. Cannegieter SC, Rosendaal FR, Briet E. Thromboembolic and bleeding complications in patients with mechanical heart valve prostheses. Circulation 1994, 89:635-41.
74. D'Agostino RB, Wolf PA, Belanger AJ, Kannel WB. Stroke risk profile: adjustment for antihypertensive medication. The Framingham Study. Stroke 1994, 25:40-3.
75. Gorter JW. Major bleeding during anticoagulation after cerebral ischemia: patterns and risk factors. Stroke Prevention In Reversible Ischemia Trial (SPIRIT). European Atrial Fibrillation Trial (EAFT) study groups. Neurology 1999, 53:1319-27.
76. Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't. BMJ 1996, 312:71-2.