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In the setting of atrial fibrillation or a mechanical heart valve, warfarin use is effective for preventing ischemic stroke, but it produces a small increase in risk for intracranial hemorrhage. With warfarin use increasing and the population aging, warfarin-associated intracerebral hemorrhage (WICH) is becoming more common.
In a retrospective series of 88 patients with WICH and international normalized ratios (INR) of 1.5 or greater, investigators identified predictors of poor clinical outcome and hematoma expansion. In univariate analyses, lower initial Glasgow Coma Scale score, larger initial hematoma volume, elevated blood glucose, and hematoma expansion each predicted mortality within both 7 days and 1 year and poor functional outcomes …