J Clin Neurol.  2008 Sep;4(3):131-133. 10.3988/jcn.2008.4.3.131.

Warfarin-Induced Intracerebral Hemorrhage Associated with Microbleeds

• Lee GH
• Kwon SU
• Kang DW

• KMID: 2287677
• DOI: http://doi.org/10.3988/jcn.2008.4.3.131

Abstract

BACKGROUND: Microbleeds (MBs), proposed as a biomarker for microangiopathy, have been suggested as a predictor of spontaneous or thrombolysis-related intracerebral hemorrhage (ICH) in acute ischemic stroke. However, the relationship between MBs and warfarin-induced ICH is not clear.
CASE REPORT
We describe two patients who developed warfarin-induced ICH at the site of MBs documented in previous MRI.
CONCLUSIONS
The presence of MBs might increase the risk of ICH after warfarin use in ischemic stroke patients. A large cohort study is required to confirm the relationship of MBs with warfarin-induced ICH.

Keyword

Anticoagulation; Intracerebral hemorrhage; Magnetic resonance imaging

MeSH Terms

Cerebral Hemorrhage
Cohort Studies
Humans
Magnetic Resonance Imaging
Stroke
Warfarin
Warfarin

Figure

• 

  Fig. 1 Gradient-echo (GRE) images of case 1. A: Acute intracerebral hemorrhage (ICH) was observed in the left parietal lobe. B: GRE images taken 5 years previously showed an intracerebral microbleed (MB) in the left parietal lobe at the site of acute ICH.

• 

  Fig. 2 CT and GRE images of case 2. A: Acute pontine hemorrhage was observed on CT. B: GRE images taken 2 years previously showed an MB at the site where acute ICH developed. GRE: Gradient-echo, ICH: Intracerebral Hemorrhage.

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