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ORIGINAL ARTICLE
Year : 2016  |  Volume : 12  |  Issue : 4  |  Page : 169-171

‘TIME IS BRAIN’ for Haemorrhagic Stroke Secondary to Warfarin Therapy in the Elderly


Department of Stroke Medicine, University Hospital of North Staffordshire, and Keele University, Stoke on Trent, UK

Correspondence Address:
A Shabir
Department of Stroke Medicine, University Hospital of North Staffordshire, and Keele University, Stoke on Trent
UK
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Source of Support: None, Conflict of Interest: None


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Intra-cerebral haemorrhage (ICH) is a rare complication of warfarin that is life-threatening and requires emergent treatment. Also, as ICH is unpredictable, large cohort studies are not possible especially in elderly patients. Treatment will continue to be based on case series and clinical experience. We present observational study of 4 cases of elderly patients with haemorrhagic stroke secondary to warfarin therapy with supratherapeutic INR. All patients received 10mg IV Vitamin K and 4 factor Human Prothrombin Complex Concentrate (Octaplex) for warfarin reversal. Of the 4 patients, 2 patients had good clinical outcome due to prompt reversal of INR with octaplex, while the other 2 patients had fatal outcome due to delay in warfarin reversal. Our study though small reiterates, as ‘Time is Brain’ in ischaemic strokes, likewise it holds true for haemorrhagic strokes. Larger trials are required to assess time for "door to reversal" similar to "door to needle" in stroke thrombolysis.


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