Abstract
Spontaneous (non-traumatic) intracranial haemorrhage (SICH) during anticoagulant and antiplatelet therapy is a devastating event and a highly significant cause of morbidity and mortality worldwide; the incidence of SICH has been growing since the early 1990s matching the increasing use of anticoagulant treatment in patients suffering from atrial fibrillation, stroke, pulmonary thromboembolism and deep venous thrombosis. The increment of SICH is even more remarkable in patients aged >80 years together with the increasing age of population. A further risk factor is the introduction of new oral anticoagulants whose utilisation is easier for the patients but exposes them to the same haemorrhagic risk; antagonist drugs are under study and could be available soon.
SICH could be prevented with careful management of anticoagulant therapy. Management of SICH in a neurointensive unit appears to improve outcome; care is based on minimising ongoing bleeding with early reversal of anticoagulation, standardised intensive monitoring and surgical treatment in selected patients.
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Fumagalli, P. (2015). Optimum Management of Perioperative Coagulation in Patients with Spontaneous Intracranial Haemorrhage. In: Chiumello, D. (eds) Practical Issues Updates in Anesthesia and Intensive Care. Springer, Cham. https://doi.org/10.1007/978-3-319-18066-3_8
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DOI: https://doi.org/10.1007/978-3-319-18066-3_8
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