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Departments of Neurology (Drs. Kase and Robinson) and Radiology (Drs. Harp and williams), University of South Alabama, Mobile, AL; the Department of Neurology (Drs. Stein, Hier, and Caplan), Michael Reese Hospital, Chicago, IL; the Department of Neurology (Dr. DeWitt), Massachusetts General Hospital, Boston, MA; and the Neurological Institute (Dr. Mohr), Columbia-Presbyterian Medical Center, New York, NY.
Twenty-four patients had intracerebral hemorrhage while they were being treated with anticoagulants. Hypertension was present in 67% of the cases, head trauma was an uncommon preceding event, and simultaneous bleeding in other organs occurred in only one instance. Neurologic abnormalities progressed for several hours in 58%. Seizures occurred at onset in 12.5%. The location of the hemorrhage was as follows: cerebellum (nine cases), lobar white matter (six), basal ganglia (five), thalamus (two), and hemisphere, unspecified (two). In 61%, the hemorrhages occurred within 6 months of therapy. In 75%, the prothrombin time was beyond 11/2 times the control value. Mortality was 62.5%. Survivors had smaller hematomas than did patients with fatal hemorrhage.
Address correspondence and reprint requests to Dr. Kase, Neurology Department, Boston University School of Medicine, 720 Harrison Avenue, Suite 604, Boston, MA 02118.
Presented in part at the thirty-sixth Annual Meeting of the American Academy of Neurology, Boston, MA. April 1984.
Accepted for publication October 23, 1984.
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