Navigation Links
Management of anticoagulant-associated intracerebral hemorrhage
Date:8/1/2014

Charlottesville, VA (August 1, 2014). The Journal of Neurosurgery is pleased to announce today's publication of a supplement to the August issue entitled "Race Against the Clock: Overcoming Challenges in the Management of Anticoagulant-Associated Intracerebral Hemorrhage." Authored by Peter Le Roux, MD, Charles V. Pollack, Jr., MA, MD, Melissa Milan, MD, and Alisa Schaefer, PhD, the 20-page supplement covers the current knowledge of anticoagulant-associated intracerebral hemorrhage (AAICH) and methods in use for management of the condition. Provided by Paradigm Medical Communications, LLC, and supported by an educational grant from CSL Behring, the supplement is freely available for online review and download: http://thejns.org/toc/sup/121/Suppl. Continuing medical education (CME) credits are available to those who wish to avail themselves of the opportunity.

Intracerebral hemorrhage (ICH) is a potentially deadly form of hemorrhagic stroke. A medical emergency, ICH occurs when blood escapes into brain tissue from an injured or diseased blood vessel. Increased blood in the brain builds up pressure within the skull, which can cause unconsciousness and death. Interruption of normal blood flow deprives parts of the brain of the oxygen that is required. Degradation of pooled blood products in the brain damages and can kill brain cells. To reduce the harmful effects of ICH, swift medical and/or surgical treatment is essential. Nevertheless, more than one-third of patients will not survive and only 20% of patients will regain functional independence following ICH.

Management of ICH poses a greater challenge when it occurs in patients who receive anticoagulation therapy, because the decreased ability of blood to clot leads to larger hemorrhages. Anticoagulants are prescribed for a variety of diagnoses such as atrial fibrillation, deep vein thrombosis, heart attack, and ischemic stroke. These diseases are found more frequently in older individuals, and the aging population keeps increasing. Consequently, the number of cases of anticoagulant-associated ICH (AAICH) is on the rise. Dr. LeRoux and colleagues cite a mortality rate for AAICH "as high as 42.3% to 67%"substantially higher than that of ICH as a whole. Such numbers indicate a great need to improve the treatment of AAICH.

"Race Against the clock" conveys the urgency involved in reversing the effect of anticoagulant medications in patients with ICH. In this educational supplement, Dr. Le Roux and colleagues have compiled up-to-date information on AAICH and its treatment. They offer a review of current oral anticoagulation therapies and describe various agents' mechanisms of action. Beginning with warfarin, the most well known and widely used anticoagulation agent, the authors move through newer oral anticoagulants such as the direct thrombin inhibitor dabigatran etexilate and the direct factor Xa inhibitors rivaroxaban and apixaban.

The authors review administration of vitamin K, fresh frozen plasma, prothrombin complex concentrates (both three-factor [used off label] and four-factor PCCs), and recombinant factor VIIa, as well as the use of dialysis, in reversing the effects of anticoagulants. Reversal of warfarin's effects has been widely tested, and the supplement offers a sample protocol for this. There are far fewer studies of reversal of the targeted oral anticoagulants (dabigatran etexilate, rivaroxaban, and apixaban), for which no specific antidotes have been identified as yet. The authors describe current and potential treatments used in cases of AAICH involving these agents.

The authors review the American Heart AssociationAmerican Stroke Association Guidelines for the management of spontaneous ICH. These AHA Guidelines include reversal strategies for AAICH but were written before the newer oral anticoagulants were approved for use. The authors point out that investigations of ICH treatment are ongoing and discuss a number of recent clinical trials. Also discussed are surgery for AAICH and the controversy over when to restart oral anticoagulation therapy following AAICH.

Institutional protocols for the treatment of spontaneous ICH and AAICH, involving a multidisciplinary approach, are discussed and their development in individual institutions is strongly recommended.


'/>"/>

Contact: Jo Ann Eliason
jaeliason@thejns.org
434-982-1209
Journal of Neurosurgery Publishing Group
Source:Eurekalert

Related medicine news :

1. Reputation Management India Launches a New Service Called ‘Remove Bad Reviews’
2. ReputationChief.Com Announces a New Online Reputation Management Service
3. CMSA Supports National Case Management Week Resolution Introduced in US Senate
4. Community Health Center of Snohomish Releases Article Focusing on Educating the Chronically Ill About Chronic Disease Management
5. US Pharmacy Benefit Management (PBM) Market Trends and Developments Now Available at MarketReportsOnline.com
6. Wright & Filippis Implements Brightree’s Billing and Business Management Platform
7. CMSA Presents 2014 National Case Management Awards at Annual Conference & Expo
8. Wisdom Natural Brands Announces Key Executive Management Team
9. Nonprofit Debt Management Credit Counseling Providing Low Cost Student Loan Help
10. Splashtop Joins RSA® Ready Technology Partner Program; Announces Adoption by Leading Japan Insurance Group Nissei Asset Management
11. ISI Telemanagement Solutions, Inc. Releases Infortel® Speech Analytics
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:8/20/2017)... Centennial, CO (PRWEB) , ... August 20, 2017 , ... ... in the same household? If so, you may be interested in participating in ... The purpose of this research is to understand more about the relational aspects of ...
(Date:8/19/2017)... York, New York (PRWEB) , ... August 19, ... ... Street Health has announced that it is the first organization with pending recognition ... CDC’s National Diabetes Prevention Program (“DPP”) via group telehealth classes and live video ...
(Date:8/19/2017)... ... August 19, 2017 , ... Physician Partners ... Orlando location as an interventional pain management physician. He brings a wealth of ... of migraine headaches, and significant experience in spinal cord stimulation for chronic pain. ...
(Date:8/18/2017)... ... August 18, 2017 , ... ... specialized asset-light logistics provider of complex transport solutions for mission-critical and non-discretionary ... Unitrans International Corporation, a division of Roadrunner Transportation Systems, Inc. (NYSE: RRTS). ...
(Date:8/18/2017)... ... ... The Dawn Johnson Insurance Group, a Missouri-based insurance and financial planning firm ... for efforts to educate the local population on cancer realities while attracting donations to ... , Each day in America, roughly 4,600 new cases of cancer are diagnosed and ...
Breaking Medicine News(10 mins):
(Date:7/28/2017)... July 28, 2017 Hill-Rom Holdings, Inc. ("Hill-Rom") ... third quarter ended June 30, 2017, and updated its ... For the fiscal third quarter, Hill-Rom ... $0.68 per diluted share in the prior-year period. These ... $0.39 per diluted share primarily related to the non-cash ...
(Date:7/27/2017)... July 27, 2017  West Pharmaceutical Services, Inc. (NYSE: ... for the second-quarter 2017 and updated financial guidance for ... Second-Quarter 2017 Highlights Reported net sales ... the prior-year quarter. Net sales at constant currency (organic) ... EPS was $0.51, compared to $0.60 in the prior-year ...
(Date:7/26/2017)... , July 26, 2017 Sancilio Pharmaceuticals ... of our clinical trial evaluating Altemia TM , an ... (SCA) and Sickle Cell Disease (SCD). The SCOT Trial, ... the efficacy and safety of Altemia TM in ... conducted under US IND 125274. ...
Breaking Medicine Technology: