naa a22 4500 510800335 CHVBK 20180411083352.0 cr unu---uuuuu 180411e20130401xx s 000 0 eng 10.1007/s12028-012-9814-x doi (NATIONALLICENCE)springer-10.1007/s12028-012-9814-x Coagulopathy Disproportionately Predisposes to Lobar Intracerebral Hemorrhage [Elektronische Daten] [Matthew Maas, Neil Rosenberg, Adam Kosteva, Shyam Prabhakaran, Andrew Naidech] Background: Anticoagulation increases the risk of intracerebral hemorrhage (ICH), yet whether different underlying disease processes are equally affected is unknown. We tested the hypothesis that coagulopathy, measured by admission international normalized ratio (INR), disproportionately increases the risk for lobar hemorrhages. Methods: Patients with primary ICH were enrolled into a registry between December 2006 and February 2012 with prospective data acquisition and systematic follow up. Logistic regression was used to test whether lobar versus deep ICH location was independently associated with INR, and then whether INR had an influence on mortality. Spearman's correlation coefficient was used to test for an association between INR and hematoma volume separately in the lobar and deep ICH groups. Results: 221 patients were studied. Patients with lobar ICH were older (71 vs. 62years old, p<0.001) and more likely to have prior ICH (10 vs. 0%, p<0.001). INR >1.4 was observed on admission more frequently in lobar versus deep ICH (19 vs. 8%, p=0.02). Lobar ICH location was independently associated with INR >1.4 (OR: 2.51, 95% CI: 1.03-6.14, p=0.043). ICH volume correlated with INR in lobar ICH (p=0.009), but not deep ICH (p=0.8). Death at 1month was independently associated with INR >1.4 (OR: 7.6, 95% CI: 2.4-24.1, p=0.001) after correction for the ICH Score. Conclusions: Abnormal coagulation occurs disproportionally in lobar versus deep ICH, and is associated with larger ICH volumes and higher mortality. These findings suggest a unique risk interaction between coagulopathy and underlying brain pathology due to cerebral amyloid angiopathy. Springer Science+Business Media New York, 2013 Anticoagulation nationallicence Coagulopathy nationallicence Intracerebral hemorrhage nationallicence Maas Matthew Department of Neurology, Northwestern University, 710N Lake Shore Drive, 11th Floor, 60611, Chicago, IL, USA aut Rosenberg Neil Department of Neurology, Northwestern University, 710N Lake Shore Drive, 11th Floor, 60611, Chicago, IL, USA aut Kosteva Adam Department of Neurology, Northwestern University, 710N Lake Shore Drive, 11th Floor, 60611, Chicago, IL, USA aut Prabhakaran Shyam Department of Neurology, Northwestern University, 710N Lake Shore Drive, 11th Floor, 60611, Chicago, IL, USA aut Naidech Andrew Department of Neurology, Northwestern University, 710N Lake Shore Drive, 11th Floor, 60611, Chicago, IL, USA aut Neurocritical Care Humana Press Inc 18/2(2013-04-01), 166-169 1541-6933 18:2<166 2013 18 12028 https://doi.org/10.1007/s12028-012-9814-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-012-9814-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Maas Matthew Department of Neurology, Northwestern University, 710N Lake Shore Drive, 11th Floor, 60611, Chicago, IL, USA aut NATIONALLICENCE 700 1- Rosenberg Neil Department of Neurology, Northwestern University, 710N Lake Shore Drive, 11th Floor, 60611, Chicago, IL, USA aut NATIONALLICENCE 700 1- Kosteva Adam Department of Neurology, Northwestern University, 710N Lake Shore Drive, 11th Floor, 60611, Chicago, IL, USA aut NATIONALLICENCE 700 1- Prabhakaran Shyam Department of Neurology, Northwestern University, 710N Lake Shore Drive, 11th Floor, 60611, Chicago, IL, USA aut NATIONALLICENCE 700 1- Naidech Andrew Department of Neurology, Northwestern University, 710N Lake Shore Drive, 11th Floor, 60611, Chicago, IL, USA aut NATIONALLICENCE 773 0- Neurocritical Care Humana Press Inc 18/2(2013-04-01), 166-169 1541-6933 18:2<166 2013 18 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer