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Issue: Issue 6 (2019) – Supplement 1


Debate

Is there a role for reversal agents in anticoagulant associated ICH?

Author(s):
João Sargento Freitas
Abstract:
Intracerebral hemorrhage (ICH) is a potentially devastating medical condition and its treatment recommendations are not always consensual between scientific organizations and physicians. This is particularly the case in ICH of patients taking anticoagulants. The first controversy is immediately in its definition. What is “anticoagulant associated ICH”? Is there really such a condition in humans? Is there any pathological distinction from other ICH or is anticoagulant use and ICH just two conditions that may coexist and potentiate each other? It should be noted that it is widely recognized by observational studies that impaired haemostasis is a predictor of worse outcome after ICH. However, to date, no randomized study has demonstrated an improvement in clinical outcome by using reversal agents in this setting. Therefore, treating guidelines either state that no formal recommendations can be made or provide suggestions of approaches with weak evidence. During this session the existing data to support pathological backgrounds and treatment options will be critically reviewed, aiming to promote the discussion on this important topic of everyday clinical care.

From the Lisbon Stroke Summit, Lisbon, Portugal. 5–6 April 2019.

International Journal of Clinical Neurosciences and Mental Health 2019; 6(Suppl. 1):D4
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