Coagulopathy reversal in intracerebral haemorrhage

Sweidan, Alexander J; Singh, Navneet Kaur; Conovaloff, Joseph L; Bower, Matthew M.; Groysman, Leonid; Shafie, Mohammad; Yu, Wengui

doi:10.1136/svn-2019-000274

Cited by 10 publications

(8 citation statements)

References 51 publications

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“…This study highlights the need for additional consensus guidelines for early recognition and treatment of intracranial hemorrhage in patients with COVID-19 [39]. Intensive blood pressure control and coagulopathy reversal may translate to a better clinical outcome in these patients [40,41]. Further, raised intracranial pressure (ICP) is related to mortality in comatose patients with intracranial hemorrhage, and ICP monitoring may be useful in guiding therapy, especially the timing and selection of patients for surgery [42].…”

Section: Discussionmentioning

confidence: 99%

Clinical and Imaging Characteristics in Patients with SARS-CoV-2 Infection and Acute Intracranial Hemorrhage

Nawabi

Morotti²,

Wildgruber

et al. 2020

JCM

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Background and Purpose: Intracranial hemorrhage has been observed in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19), but the clinical, imaging, and pathophysiological features of intracranial bleeding during COVID-19 infection remain poorly characterized. This study describes clinical and imaging characteristics of patients with COVID-19 infection who presented with intracranial bleeding in a European multicenter cohort. Methods: This is a multicenter retrospective, observational case series including 18 consecutive patients with COVID-19 infection and intracranial hemorrhage. Data were collected from February to May 2020 at five designated European special care centers for COVID-19. The diagnosis of COVID-19 was based on laboratory-confirmed diagnosis of SARS-CoV-2. Intracranial bleeding was diagnosed on computed tomography (CT) of the brain within one month of the date of COVID-19 diagnosis. The clinical, laboratory, radiologic, and pathologic findings, therapy and outcomes in COVID-19 patients presenting with intracranial bleeding were analyzed. Results: Eighteen patients had evidence of acute intracranial bleeding within 11 days (IQR 9–29) of admission. Six patients had parenchymal hemorrhage (33.3%), 11 had subarachnoid hemorrhage (SAH) (61.1%), and one patient had subdural hemorrhage (5.6%). Three patients presented with intraventricular hemorrhage (IVH) (16.7%). Conclusion: This study represents the largest case series of patients with intracranial hemorrhage diagnosed with COVID-19 based on key European countries with geospatial hotspots of SARS-CoV-2. Isolated SAH along the convexity may be a predominant bleeding manifestation and may occur in a late temporal course of severe COVID-19.

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Section: Discussionmentioning

confidence: 99%

Clinical and Imaging Characteristics in Patients with SARS-CoV-2 Infection and Acute Intracranial Hemorrhage

Nawabi

Morotti²,

Wildgruber

et al. 2020

JCM

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“…Coagulopathy-associated ICH is an additional risk factor for mortality and poor functional outcome with hematoma expansion which may occur within one hour in up to 25% of patients and within four hours in 88% of patients. Anticoagulant-related ICH is a medical emergency that requires emergent reversal [ 5 ]. Oral anticoagulation use is increasing due to the aging population and the associated increase in patients with cardiovascular comorbidities.…”

Section: Discussionmentioning

confidence: 99%

“…Warfarin interferes with the production of vitamin K-dependent clotting factors II, VII, IX, and X by depleting vitamin K reserve [ 5 ]. Warfarin-related coagulopathy is usually treated with Prothrombin Complex Concentrate (PCC) which corrects coagulopathy by replacing all four vitamin K-dependent factors.…”

Section: Discussionmentioning

confidence: 99%

Intraparenchymal Hematoma With Significant Mass Effect Treated With Factor Eight Inhibitor Bypass Activity

Prasad¹,

Figueroa²,

Stead³

et al. 2022

Cureus

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The authors present the case of an 80-year-old female with myelodysplastic syndrome treated with chemotherapy and apixaban, a direct oral anticoagulant who suffered an intracranial hemorrhage. She presented to the emergency department with altered mental status and was found to have a large intraparenchymal hematoma with a significant mass effect. Our patient was given FEIBA (Factor Eight Inhibitor Bypass Activity) to reverse the hemorrhage. Anticoagulant-related bleeding reversal strategies are discussed.

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“…The theoretical risk of bleeding in the event of AAA rupture has hindered trials investigating the effect of anticoagulants on ILT. The introduction of antidotes and improved monitoring of the therapeutic effect of anticoagulants 29 , in combination with the abilities of 3D-CEUS for a more reliant ILT assessment, pave the way for large scale RCT's to assess the effect of NOACs on ILT-burden, AAA growth and cardiovascular events.…”

Section: J O U R N a L P R E -P R O O F 11mentioning

confidence: 99%

Anticoagulants and reduced thrombus load in abdominal aortic aneurysms assessed with three-dimensional contrast-enhanced ultrasound examination

Skov

Eiberg²,

Rouet³

et al. 2023

Journal of Vascular Surgery

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Coagulopathy reversal in intracerebral haemorrhage

Cited by 10 publications

References 51 publications

Clinical and Imaging Characteristics in Patients with SARS-CoV-2 Infection and Acute Intracranial Hemorrhage

Clinical and Imaging Characteristics in Patients with SARS-CoV-2 Infection and Acute Intracranial Hemorrhage

Intraparenchymal Hematoma With Significant Mass Effect Treated With Factor Eight Inhibitor Bypass Activity

Anticoagulants and reduced thrombus load in abdominal aortic aneurysms assessed with three-dimensional contrast-enhanced ultrasound examination

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