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Updated: Jul 11, 2026
04:56
Determination of the Procoagulant Activity of Extracellular Vesicle (EV) Using EV-Activated Clotting Time (EV-ACT)
Published on: August 4, 2023
Coagulation abnormalities following primary intracerebral hemorrhage
Venkatakrishna Rajajee1, David M Brown, Stanley Tuhrim
1Department of Neurology, Mount Sinai Medical Center, New York, New York, USA. vrajajee@earthlink.net
Summary
Primary intracerebral hemorrhage (PICH) can cause coagulation abnormalities in 8.4% of patients. These bleeding disorders are linked to worse outcomes, including neurological decline and increased mortality, suggesting a potential therapeutic target.
Area of Science:
- Neurology
- Hematology
- Critical Care Medicine
Background:
- Systemic hemostatic activation is a known complication of primary intracerebral hemorrhage (PICH), especially with intraventricular or subarachnoid extension.
- Pre-existing coagulopathies can complicate the assessment of hemostatic changes in PICH patients.
Purpose of the Study:
- To investigate the incidence of coagulation abnormalities (partial thromboplastin time, international normalized ratio, platelet count) in PICH patients.
- To identify potential causes for coagulopathy in PICH patients without evident pre-existing conditions.
- To correlate coagulation abnormalities with clinical outcomes in PICH.
Main Methods:
- Retrospective chart review of 192 PICH patients admitted between November 1991 and December 2001.
- Exclusion of patients with underlying lesions, trauma, anticoagulation, liver failure, or sepsis.
- Analysis of admission partial thromboplastin time, international normalized ratio, and platelet count; abnormal values defined by laboratory standards. Computed tomography (CT) scans were used for diagnosis and monitoring.
Main Results:
- Coagulopathy was identified in 13 of 155 (8.4%) eligible PICH patients.
- Patients with coagulopathy showed significantly higher rates of neurological deterioration with hematoma enlargement (23% vs 2%, P = .008).
- Intraventricular/subarachnoid extension (17% vs 2%, P = .002) and 30-day mortality (61% vs 20%, P = .003) were more frequent in patients with coagulopathy.
Conclusions:
- Coagulation abnormalities, potentially indicating low-grade disseminated intravascular coagulation, occur in 8.4% of PICH patients without obvious causes.
- These hemostatic derangements are associated with adverse outcomes, including hemorrhage extension, neurological deterioration, and increased mortality.
- Identifying and treating these coagulation abnormalities in PICH patients may represent a valuable therapeutic strategy.
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