Evaluation of Oral Anticoagulant Associated Intracranial Parenchymal Hematomas Using CT Findings        
Yazarlar (3)
Prof. Dr. Erkan GÖKÇE Tokat Gaziosmanpaşa Üniversitesi, Türkiye
Doç. Dr. Murat BEYHAN Zile State Hospital, Türkiye
B. Acu
Eskişehir Osmangazi Üniversitesi, Türkiye
Makale Türü Özgün Makale
Makale Alt Türü SSCI, AHCI, SCI, SCI-Exp dergilerinde yayınlanan tam makale
Dergi Adı Clinical Neuroradiology
Dergi ISSN 1869-1439 Wos Dergi Scopus Dergi
Dergi Tarandığı Indeksler SCI-Expanded
Dergi Grubu Q4
Makale Dili İngilizce
Basım Tarihi 06-2015
Cilt No 25
Sayı 2
Sayfalar 151 / 159
DOI Numarası 10.1007/s00062-014-0292-8
Makale Linki https://link.springer.com/article/10.1007/s00062-014-0292-8
Özet
Purpose: Intracranial hemorrhage (ICH) is one of the most serious and lethal complications of anticoagulants with a reported incidence of 5–18.5 %. Computed tomographic (CT) findings, should be carefully studied because early diagnosis and treatment of oral anticoagulant use-associated hematomas are vitally important. In the present study, CT findings of intraparenchymal hematomas associated with anticoagulant and antihypertensive use are presented. Methods: This study included 45 patients (25 men, 20 women) under anticoagulant (21 patients) or antihypertensive (24 patients) treatment who had brain CT examinations due to complaints and findings suggesting cerebrovascular disease during July 2010–October 2013 period. CT examinations were performed to determine hematoma volumes and presence of swirl sign, hematocrit effect, mid-line shift effect, and intraventricular extension. Results: The patients were 40–89 years of age. In four cases, a total of 51 intraparenchymal hematomas (42 cerebral, 7 cerebellar and 2 brain stem) were detected in multiple foci. Hematoma volumes varied from 0.09 to 284.00 ml. Swirl sign was observed in 87.5 and 63.0 % of OAC-associated ICHs and non-OAC-associated ICHs, respectively. In addition, hematocrit effect was observed in 41.6 % of OAC-associated and in 3.7 % of non-OAC-associated ICHs. Volume increases were observed in all 19 hematomas where swirl sign was detected, and follow-up CT scanning was conducted. Mortality of OAC-associated ICHs was correlated with initial volumes of hematoma, mid-line shift amount, and intraventricular extension. Conclusions: Detection of hematocrit effect by CT scanning of intracranial hematomas should be cautionary in oral anticoagulant use, while detection of swirl sign should be suggestive of active hemorrhage.
Anahtar Kelimeler
Computed tomography | Hematocrit effect | Intracranial hemorrhage | Oral anticoagulant | Swirl sign