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Oral anticoagulant therapy in patients after intracerebral hemorrhage

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The presence of indications for long-term oral anticoagulant (OAC) therapy in a patient who has experienced an intracerebral hemorrhage (IUD) poses a difficult clinical dilemma for the physician. The article discusses the vectors of recurrence for different types of IUD and their neuroimaging markers. It describes approaches to the global assessment of risk factors for IUD in patients taking OACs. Detailed consideration is given to the situation of IUD concurrent with atrial fibrillation as the most common reason for prescribing OACs. There are data on the safety of restating OACs after IUD and on the risk of the latter in patients taking warfarin and direct OACs. The optimal OAC start or restart time after IUD, including that in patients with prosthetic valves, is discussed. An algorithm for decision making is recommended.

About the Authors

A. A. Kulesh
Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia
Russian Federation

Aleksey Aleksandrovich Kulesh.

2, Kim St., Perm 614107.

Competing Interests: There are no conflicts of interest.

L. I. Syromyatnikova
Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia
Russian Federation

2, Kim St., Perm 614107.

Competing Interests: There are no conflicts of interest.


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Kulesh A.A., Syromyatnikova L.I. Oral anticoagulant therapy in patients after intracerebral hemorrhage. Neurology, Neuropsychiatry, Psychosomatics. 2020;12(3):4-10.

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