Reversal of Anticoagulation in Intracranial Hemorrhage

Patients who present with intracranial hemorrhage (ICH) require prompt diagnosis and emergent treatment. Anticoagulants are an independent predictor of poor outcomes in patients with acute ICH patients. Therefore, discontinuation of the offending medication and anticoagulation reversal, along with aggressive blood pressure management, is of utmost importance. This article provides a review of anticoagulation-associated ICH, including common anticoagulant medications and reversal agents. Evidence-based guidelines are applied to explain the current medical management paradigm as well as emerging therapies to improve patient outcomes.