[Neurological complications of anticoagulants (author's transl)]

Abstract

During a course of therapy by anticoagulants, 16 intracranial haemorrhages and 10 cerebral infarctions, were observed over a period of seven years. The intracranial haemorrhages include 11 subdural haematomas (four acute, seven chronic) and ive intracerebral haemorrhages, one of which resulted from the rupture of an arterial aneurysm. The anticoagulant therapy lasted in 12 cases for more than two years, and in four cases between twenty-four hours and two months. Monocoumarinics are most often the cause of the haemorrhages. The subdural haematomas are unpredictable and a traumatism was only observed in four cases. Three out of four patients with acute haematomas died, as well as two out of seven patients with chronic haematomas. Three out of four intracerebral haemorrhages occurred after ischemic cerebral accidents. The existence of a cerebral infarction counter-indicates the use of anticoagulants. The cerebral infarctions occurred five times during the anticoagulation therapy, and five times after stopping the treatment (from within a few days to a few weeks). Anticoagulation therapy, apart from infarction, is in general well supported and well supervised during the first weeks. Used for a long time, it may lead to very serious and often fatal complication, and must therefore be weighed against the advantages of the treatment.