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
-
Dysfunctions of the Diffusional Membrane Pathways Mediated Hemichannels in Inherited and Acquired Human Diseases
Current Vascular Pharmacology Duloxetine in the Treatment of Depression: An Overview
Central Nervous System Agents in Medicinal Chemistry GABAA Receptors in Normal Development and Seizures: Friends or Foes?
Current Neuropharmacology Advances of Mesenchymal Stem Cells Derived from Bone Marrow and Dental Tissue in Craniofacial Tissue Engineering
Current Stem Cell Research & Therapy Basis for the Application of Analytical Models of the Bloch NMR Flow Equations for Functional Magnetic Resonance Imaging (fMRI): A Review
Recent Patents on Medical Imaging Protein Glycation: An Old Villain is Shedding Secrets
Combinatorial Chemistry & High Throughput Screening Current Management of Fetal and Neonatal Renal Tumors
Current Pediatric Reviews Novel Functions of MicroRNA-17-92 Cluster in the Endocrine System
Current Drug Targets The Use of the Zebrafish Model to Aid in Drug Discovery and Target Validation
Current Topics in Medicinal Chemistry The Safety of Medications for the Treatment of Bipolar Disorder During Pregnancy and the Puerperium
Current Drug Safety P-gp Transporter and its Role in Neurodegenerative Diseases
Current Topics in Medicinal Chemistry Female Infertility and Antioxidants
Current Women`s Health Reviews An Enriched Population of CD45, CD34 and CD117 Stem Cells in Human Umbilical Cord Blood for Potential Therapeutic Regenerative Strategies
Current Neurovascular Research Nimodipine Reappraised: An Old Drug With a Future
Current Neuropharmacology Pregnancy in Type 2 Diabetes Mellitus - Problems & Promises
Current Diabetes Reviews Clinical Characteristics and Treatment of Cardiomyopathies in Children
Current Cardiology Reviews Targeting TNF-Alpha to Elucidate and Ameliorate Neuroinflammation in Neurodegenerative Diseases
CNS & Neurological Disorders - Drug Targets Heart Transplantation in Biventricular Congenital Heart Disease: Indications, Techniques, and Outcomes
Current Cardiology Reviews Low Estimated Glomerular Filtration Rate is Associated with High Recurrence Rate and Poor Prognosis of Hemorrhage Stroke
Current Neurovascular Research Sex Impact on Biomarkers, Pharmacokinetics and Pharmacodynamics
Current Medicinal Chemistry