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NEUROLOGY 1998;50:1489-1491
© 1998 American Academy of Neurology

Early anticoagulation in patients with prosthetic heart valves and intracerebral hematoma

R. R. Leker, MD and O. Abramsky, MD, PhD

From the Department of Neurology, Hebrew University-Hadassah Medical School, Jerusalem, Israel.

Address correspondence and reprint requests to Dr Leker, Department of Neurology, Hadassah Medical Center, POB 12000, Jerusalem 91120, Israel.

Anticoagulants are generally contraindicated in patients with intracerebral hematoma. However, in patients with prosthetic heart valves it may be dangerous to withhold such therapy because of possible thromboembolic complications. We treated four such patients with IV heparin starting early after the hemorrhage. The hematomas receded in all patients according to the follow-up CTs, and none had thromboembolic disorders. Three patients had good outcomes, and one remained in a persistent vegetative state after an event of acute pulmonary edema.

Supported in part by the Sol Irwin Juni Endowment Fund.

Received July 7, 1997. Accepted in final form October 8, 1997.




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