Intracerebral hematomas during anticoagulant treatment

We retrospectively studied 79 patients from three centers who suffered an intracerebral hemorrhage during treatment with anticoagulants and compared them with 84 patients from one center who suffered a spontaneous intracerebral hemorrhage without anticoagulant treatment. Mortality after 30 days was slightly higher in patients with anticoagulant treatment (67%) than in those without (55%), and the proportion of patients who attained moderate or complete recovery was slightly smaller in the treated group (22% and 36%, respectively); neither difference was statistically significant. Volume of the supratentorial hematoma was measured from computed tomograms in 70% of the patients in both groups and was significantly greater in the 55 patients treated with anticoagulants than in the 59 patients not so treated. Volume was not related to the degree of anticoagulation. Based on the total number of patients treated with anticoagulants in the Heerlen region, we conclude that for patients older than 50 years of age the risk of intracerebral hemorrhage during anticoagulant treatment is increased approximately eightfold but is unrelated to the degree of anticoagulation. Our results suggest that intracerebral hemorrhage is more frequent and more extensive in patients treated with anticoagulants but that once it has occurred in such patients intracerebral hemorrhage is not significantly more serious than in untreated patients.