Acute Management of Anticoagulation-Associated Intracerebral Hemorrhage

Kuramatsu, Joji B.; Gerner, Stefan T.; Huttner, Hagen B.; Schwab, Stefan

doi:10.1055/s-0043-108836

Cited by 2 publications

(2 citation statements)

References 108 publications

(132 reference statements)

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“…37,46,47 Hematoma expansion with clinical worsening after application of idarucizumab was observed only in 11% of cases staying substantially below rates reported to be between 25% and 35% in the literature. 41–45 This positive effect of idarucizumab on the risk of hematoma expansion corresponds with favorable outcome (mRS 0–3) in 61% of cases in our cohort, representing an impressive improvement when compared to other recent reports with favorable outcomes of 24% 37 or 47%, 46 respectively.…”

Section: Discussionsupporting

confidence: 68%

“…In our retrospective analysis, the in-hospital mortality for all intracranial bleeds and also for intracerebral bleeds after dabigatran reversal with idarucizumab remained below 15% which was low in comparison to recent reports of 90-day mortality rates of NOAC-associated ICH between 25% and 40%. 41–45 Data on in-hospital mortality in case of NOAC associated ICH are rare and restricted to few publications in 2018 in which mortality at discharge was markedly higher and ranged from 18% to 27%. 37,46,47 Hematoma expansion with clinical worsening after application of idarucizumab was observed only in 11% of cases staying substantially below rates reported to be between 25% and 35% in the literature.…”

Section: Discussionmentioning

confidence: 99%

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Antagonizing dabigatran by idarucizumab in cases of ischemic stroke or intracranial hemorrhage in Germany—Updated series of 120 cases

Kermer

Eschenfelder

Diener

et al. 2020

International Journal of Stroke

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Background Idarucizumab is a monoclonal antibody fragment with high affinity for dabigatran reversing its anticoagulant effects within minutes. Thereby, patients with acute ischemic stroke who are on dabigatran treatment may become eligible for thrombolysis with recombinant tissue-type plasminogen activator (rt-PA). In patients on dabigatran with intracerebral hemorrhage idarucizumab could prevent lesion growth. Aims To provide insights into the clinical use of idarucizumab in patients under effective dabigatran anticoagulation presenting with signs of acute ischemic stroke or intracranial hemorrhage. Methods Retrospective data collected from German neurological/neurosurgical departments administering idarucizumab following product launch from January 2016 to August 2018 were used. Results One-hundred and twenty stroke patients received idarucizumab in 61 stroke centers. Eighty patients treated with dabigatran presented with ischemic stroke and 40 patients suffered intracranial bleeding (intracerebral hemorrhage (ICH) in n = 27). In patients receiving intravenous thrombolysis with rt-PA following idarucizumab, 78% showed a median improvement of 7 points in National Institutes of Health Stroke Scale. No bleeding complications were reported. Hematoma growth was observed in 3 out of 27 patients with ICH. Outcome was favorable with a median National Institutes of Health Stroke Scale improvement of 4 points and modified Rankin score 0–3 in 61%. Six out of 40 individuals (15%) with intracranial bleeding died during hospital stay. Conclusion Administration of rt-PA after reversal of dabigatran activity with idarucizumab in case of acute ischemic stroke seems feasible, effective, and safe. In dabigatran-associated intracranial hemorrhage, idarucizumab appears to prevent hematoma growth and to improve outcome.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Antagonizing dabigatran by idarucizumab in cases of ischemic stroke or intracranial hemorrhage in Germany—Updated series of 120 cases

Kermer

Eschenfelder

Diener

et al. 2020

International Journal of Stroke

Self Cite

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Neurobiological effects of gallic acid: current perspectives

et al. 2023

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Gallic acid (GA) is a phenolic molecule found naturally in a wide range of fruits as well as in medicinal plants. It has many health benefits due to its antioxidant properties. This study focused on finding out the neurobiological effects and mechanisms of GA using published data from reputed databases. For this, data were collected from various sources, such as PubMed/Medline, Science Direct, Scopus, Google Scholar, SpringerLink, and Web of Science. The findings suggest that GA can be used to manage several neurological diseases and disorders, such as Alzheimer’s disease, Parkinson’s disease, strokes, sedation, depression, psychosis, neuropathic pain, anxiety, and memory loss, as well as neuroinflammation. According to database reports and this current literature-based study, GA may be considered one of the potential lead compounds to treat neurological diseases and disorders. More preclinical and clinical studies are required to establish GA as a neuroprotective drug.

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Acute Management of Anticoagulation-Associated Intracerebral Hemorrhage

Abstract: One of the most serious forms of stroke is intracerebral hemorrhage (ICH) as fewer than 30 % of patients recover to functional independence and the one-year mortality rate of over 50 % is very high [1][2][3].

Cited by 2 publications

References 108 publications

Antagonizing dabigatran by idarucizumab in cases of ischemic stroke or intracranial hemorrhage in Germany—Updated series of 120 cases

Antagonizing dabigatran by idarucizumab in cases of ischemic stroke or intracranial hemorrhage in Germany—Updated series of 120 cases

Neurobiological effects of gallic acid: current perspectives

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