Abstract
Background: Intracerebral hemorrhage is the pathological accumulation of blood within the brain. It is a type of stroke more likely to be lethal or to severely disable the patient and results from a wide variety of causes. On the other hand antithrombotic therapy is used for the prevention or/and the therapy of thromboembolic episodes. Antithrombotic drugs are very effective in reducing risk or mortality rate after a thromboembolic event, yet they are associated with significant hemorrhages.
Objective: The aim of this article is to review current literature for intracerebral hemorrhage and antithrombotic therapy and offer recommendations on the reversal, the discontinuation and the resumption of antithrombotic therapy. Methods and Materials: Current literature has been reviewed for intracerebral hemorrhage associated with three major categories of patients, those with atrial fibrillation, those with prosthetic mechanical valves and those with venous thromboembolism. Antithrombotic therapy is categorized in antiplatelet agents and anticoagulants. The risk of intracerebral hemorrhage, of a thromboembolic event and of a rebleeding with or without antithrombotic therapy was also reported. Conclusion: Although no one can deny the usefulness of antithrombotic therapy a therapeutic strategy should be developed in order to optimize the clinical decision of stopping, reversing and restarting antithrombotic treatment. This review concludes in strong recommendations, yet a multidisciplinary panel by a stroke physician or neurologist, a cardiologist, a neuroradiologist and a neurosurgeon should evaluate the benefits and the risks for each patient and decide the best therapeutic strategy.Keywords: Intracerebral hemorrhage, ICH, antiplatelets, antithrombotic agents, anticoagulation, thromboembolism.
Current Pharmaceutical Design
Title:Antithrombotic Treatment Management in Patients with Intracerebral Hemorrhage: Reversal and Restart
Volume: 23 Issue: 9
Author(s): Dimitrios Giakoumettis, George A. Alexiou, Dimitrios A. Vrachatis, Kostas Themistoklis, Pantelis Stathis, Manolis Vavuranakis and Marios S. Themistocleous*
Affiliation:
- 20 Dimitsanas street, PO: 16672, Athens,Greece
Keywords: Intracerebral hemorrhage, ICH, antiplatelets, antithrombotic agents, anticoagulation, thromboembolism.
Abstract: Background: Intracerebral hemorrhage is the pathological accumulation of blood within the brain. It is a type of stroke more likely to be lethal or to severely disable the patient and results from a wide variety of causes. On the other hand antithrombotic therapy is used for the prevention or/and the therapy of thromboembolic episodes. Antithrombotic drugs are very effective in reducing risk or mortality rate after a thromboembolic event, yet they are associated with significant hemorrhages.
Objective: The aim of this article is to review current literature for intracerebral hemorrhage and antithrombotic therapy and offer recommendations on the reversal, the discontinuation and the resumption of antithrombotic therapy. Methods and Materials: Current literature has been reviewed for intracerebral hemorrhage associated with three major categories of patients, those with atrial fibrillation, those with prosthetic mechanical valves and those with venous thromboembolism. Antithrombotic therapy is categorized in antiplatelet agents and anticoagulants. The risk of intracerebral hemorrhage, of a thromboembolic event and of a rebleeding with or without antithrombotic therapy was also reported. Conclusion: Although no one can deny the usefulness of antithrombotic therapy a therapeutic strategy should be developed in order to optimize the clinical decision of stopping, reversing and restarting antithrombotic treatment. This review concludes in strong recommendations, yet a multidisciplinary panel by a stroke physician or neurologist, a cardiologist, a neuroradiologist and a neurosurgeon should evaluate the benefits and the risks for each patient and decide the best therapeutic strategy.Export Options
About this article
Cite this article as:
Giakoumettis Dimitrios, Alexiou A. George, Vrachatis A. Dimitrios, Themistoklis Kostas, Stathis Pantelis, Vavuranakis Manolis and Themistocleous S. Marios*, Antithrombotic Treatment Management in Patients with Intracerebral Hemorrhage: Reversal and Restart, Current Pharmaceutical Design 2017; 23 (9) . https://dx.doi.org/10.2174/1381612822666161205111459
DOI https://dx.doi.org/10.2174/1381612822666161205111459 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
The Use of Statins in Respiratory Diseases
Current Respiratory Medicine Reviews BMPS and Liver: More Questions than Answers
Current Pharmaceutical Design DNA Methylation, An Epigenetic Mode of Gene Expression Regulation in Reproductive Science
Current Pharmaceutical Design Part-Time α-Secretases: The Functional Biology of ADAM 9, 10 and 17
Current Alzheimer Research Platelets in Rheumatic Diseases: Friend or Foe?
Current Pharmaceutical Design Activin Receptor-Like Kinases: Structure, Function and Clinical Implications
Endocrine, Metabolic & Immune Disorders - Drug Targets Transforming Growth Factor β Signaling Perturbation in the Loeys-Dietz Syndrome
Current Medicinal Chemistry A Healthy Gut for a Healthy Brain: Preclinical, Clinical and Regulatory Aspects
Current Neuropharmacology Community-Acquired Pneumonia in Children
Recent Patents on Inflammation & Allergy Drug Discovery Editorial [Hot topic: Modifying Cardiovascular Risk Factors: Epidemiology and Characteristics of Smoking-Related Cardiovascular Diseases (Executive Editor: Aurelio Leone)]
Current Pharmaceutical Design Why and how do Microbubbles Enhance the Effectiveness of Diagnostic and Therapeutic Interventions in Cerebrovascular Disease?
Current Pharmaceutical Design Future Challenges for Microsomal Transport Protein Inhibitors
Current Vascular Pharmacology Molecular Imaging to Monitor Repair of Myocardial Infarction Using Genetically Engineered Bone Marrow-Derived Mesenchymal Stem Cells
Current Gene Therapy Experimental and Clinical Studies on Rifacinna® - The New Effective Antituberculous Drug (Review)
Recent Patents on Anti-Infective Drug Discovery Aptamers Against Cell Surface Receptors: Selection, Modification and Application
Current Medicinal Chemistry Treatment of Epileptic Encephalopathies
Current Pharmaceutical Design Immune Endocrinological Evaluation in Patients with Severe Vascular Acquired Brain Injuries: Therapeutical Approaches
Endocrine, Metabolic & Immune Disorders - Drug Targets Genomic and Epigenetic Complexity of the FOXF1 Locus in 16q24.1: Implications for Development and Disease
Current Genomics Current Outcomes and Considerations in Hypoplastic Left Heart Syndrome
Current Pediatric Reviews Sonic Hedgehog, the Penis and Erectile Dysfunction: A Review of Sonic Hedgehog Signaling in the Penis
Current Pharmaceutical Design