Intracerebral hemorrhage risk factors
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
Common risk factors in the development of intracerebral hemorrhage (ICH) include hypertension, anticoagulation medication(warfarin), acquired or congenital coagulation factor disorder (such as vitamin K deficiency, liver disease, disseminated Intravascular Coagulation (DIC), and hemophilias), platelet abnormalities, embolic strokes, and Sickle Cell Anemia.[1][2][3][4]
Risk factors
Common risk factors in the development of intracerebral hemorrhage (ICH) include:[1][2][3][4][5][6]
- Hypertension
- Anticoagulation medication
- Vitamin K antagonists (VKAs) such as warfarin
- Acquired or congenital coagulation factor disorders
- Vitamin K deficiency
- Liver disease
- Disseminated Intravascular Coagulation (DIC)
- Hemophilias
- Acquired qualitative or quantitative platelet abnormalities
- Embolic strokes
- Sickle Cell Anemia
Other risk factors in the development of intracerebral hemorrhage (ICH) may include:[4]
- High alcohol intake
- Lower cholesterol
- Lower triglycerides
- Older age
- Black ethnicity
New anticoagulant medications such as dabigatran, rivaroxaban, and apixaban appear to be associated with a lower risk of ICH than VKAs. [7]
Microbleeds
Common risk factors in the development cerebral microbleeds include:[8][9][10][11]
- Hypertension
- Diabetes mellitus
- Cigarette smoking
- Chronic obstructive pulmonary disease (COPD)
- Age
- Male sex
References
- ↑ 1.0 1.1 Huhtakangas J, Tetri S, Juvela S, Saloheimo P, Bode MK, Hillbom M. Effect of increased warfarin use on warfarin-related cerebral hemor- rhage: a longitudinal population-based study. Stroke. 2011;42:2431– 2435. doi: 10.1161/STROKEAHA.111.615260.
- ↑ 2.0 2.1 Rådberg JA, Olsson JE, Rådberg CT. Prognostic parameters in sponta- neous intracerebral hematomas with special reference to anticoagulant treatment. Stroke. 1991;22:571–576. doi: 10.1161/01.STR.22.5.571.
- ↑ 3.0 3.1 Flaherty ML, Kissela B, Woo D, Kleindorfer D, Alwell K, Sekar P, Moomaw CJ, Haverbusch M, Broderick JP. The increasing incidence of anticoagulant-associated intracerebral hemorrhage. Neurology. 2007;68:116–121. doi: 10.1212/01.wnl.0000250340.05202.8b.
- ↑ 4.0 4.1 4.2 Ariesen MJ, Claus SP, Rinkel GJ, Algra A (2003). "Risk factors for intracerebral hemorrhage in the general population: a systematic review". Stroke. 34 (8): 2060–5. doi:10.1161/01.STR.0000080678.09344.8D. PMID 12843354.
- ↑ Bos MJ, Koudstaal PJ, Hofman A, Breteler MM (2007). "Decreased glomerular filtration rate is a risk factor for hemorrhagic but not for ischemic stroke: the Rotterdam Study". Stroke. 38 (12): 3127–32. doi:10.1161/STROKEAHA.107.489807. PMID 17962600.
- ↑ Hackam DG, Mrkobrada M (2012). "Selective serotonin reuptake inhibitors and brain hemorrhage: a meta-analysis". Neurology. 79 (18): 1862–5. doi:10.1212/WNL.0b013e318271f848. PMID 23077009. Review in: Evid Based Ment Health. 2013 May;16(2):54
- ↑ Chatterjee S, Sardar P, Biondi-Zoccai G, Kumbhani DJ. New oral anticoagulants and the risk of intracranial hemorrhage: traditional and Bayesian meta-analysis and mixed treatment comparison of random- ized trials of new oral anticoagulants in atrial fibrillation. JAMA Neurol. 2013;70:1486–1490. doi: 10.1001/jamaneurol.2013.4021
- ↑ Poels MM, Ikram MA, van der Lugt A, Hofman A, Krestin GP, Breteler MM; et al. (2011). "Incidence of cerebral microbleeds in the general population: the Rotterdam Scan Study". Stroke. 42 (3): 656–61. doi:10.1161/STROKEAHA.110.607184. PMID 21307170.
- ↑ Klarenbeek P, van Oostenbrugge RJ, Rouhl RP, Knottnerus IL, Staals J (2013). "Higher ambulatory blood pressure relates to new cerebral microbleeds: 2-year follow-up study in lacunar stroke patients". Stroke. 44 (4): 978–83. doi:10.1161/STROKEAHA.111.676619. PMID 23449261.
- ↑ Goos JD, Henneman WJ, Sluimer JD, Vrenken H, Sluimer IC, Barkhof F; et al. (2010). "Incidence of cerebral microbleeds: a longitudinal study in a memory clinic population". Neurology. 74 (24): 1954–60. doi:10.1212/WNL.0b013e3181e396ea. PMID 20548041.
- ↑ Jeerakathil T, Wolf PA, Beiser A, Hald JK, Au R, Kase CS; et al. (2004). "Cerebral microbleeds: prevalence and associations with cardiovascular risk factors in the Framingham Study". Stroke. 35 (8): 1831–5. doi:10.1161/01.STR.0000131809.35202.1b. PMID 15155954.