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67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

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Surgical management of hemorrhagic strokes caused by coumadin-related coagulopathy

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  • Taegoo Cho - Sejong General Hospital, Seongnam-si, Korea

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocP 071

doi: 10.3205/16dgnc446, urn:nbn:de:0183-16dgnc4465

Published: June 8, 2016

© 2016 Cho.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Chronic warfarin anticoagulation is the most effective therapy for attenuating the risk of stroke associated with atrial fibrilliation. Intracranial hemorrhage is the most feared and lethal complication of coumadin. We review the surgical results of intracranial hemorrhages caused by coumadin-related hemorrhagic strokes in one cardiovascular center.

Method: We reviewed retrospectively 74 consecutive patients admitted with hemorrhagic stroke (spontaneous ICH or subdural hematoma) who is taking coumadin for the anticoagulation for the past ten years in our cardiovascular center.? Demographics: Age 61 (40-77). 59 % were females.

Results: The mean coumadin dose was 3.94 mg and their mean initial PT INR was 3.09 (ranging 1.17 to 7.32). The spontaneous subdural hematoma was more common than the lobar ICH (43 to 31 = 1.38 : 1). The reoperation rate was higher with 10 % (7/74 cases). The overall mortality was 39.1 % (29/74) much higher than the 10 % mortality rate of usual hypertensive ICH, but lower than the usual 65 % fatality of coumadin-related ICH.

Conclusions: Subdural hematoma was more common than the intracerebral hematoma. Surgical evacuation was helpful to improve the outcome of the patient who had the considerable amount of hematoma caused by coumadin.