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Small vessel disease burden and intracerebral haemorrhage in patients taking oral anticoagulants
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  • Published on:
    Letter to the Editor regarding "Small vessel disease burden and intracerebral haemorrhage in patients taking oral anticoagulants"
    • Birsen Ince, Neurologist Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Neurology, Istanbul, Turkey
    • Other Contributors:
      • Gulcin Senel, Neurologist

    Dear Editor,
    We have read with interest a recent paper by Seiffge and his colleagues published in your journal (1). In their study entitled as “Small vessel disease burden and intracerebral haemorrhage in patients taking oral anticoagulants”, the authors have investigated the role of small vessel disease on intracerebral hemorrhages (ICH) associated with the use of oral anticoagulation therapy. The authors showed that the small vessel disease with medium-to-high severity, detected by either computed tomography (CT) or magnetic resonance imaging (MRI), was significantly more prevalent in patients with ICH taking oral anticoagulants in compared to those without prior anticoagulation therapy (56.1% vs 43.5% on CT, and 78.7% vs 64.5% on MRI, respectively; p<0.001). Leukoaraiosis and atrophy were also reported to be more frequent and severe in patients with ICH related to anticoagulation therapy. We think that the results of the study are considerable emphasizing the importance of small vessel disease for ICH, which should therefore be implemented among the criteria of the risk stratification scores of bleeding.

    The use of the scoring systems for the risk stratification of the intracranial bleeding is practically important in patients who are the candidates for the anticoagulation therapy. A recent study investigating the risk factors predicting ICH in patients with atrial fibrillation under anticoagulation therapy demonstrated that the presence of white matter...

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    Conflict of Interest:
    None declared.