Antiplatelet therapy, cerebral haemorrhage, Acute ICH
Anticoagulants and antiplatelet drugs are used to reduce the risk of blood clots. They are commonly known as blood thinners. But, these don’t actually thin the blood. They prevent blood clots from forming in the blood vessels or the heart. In the absence of treatment, the clots can block circulation leading to heart attack or stroke.
Generally, anticoagulants and antiplatelet drugs are assumed to be the same. These drugs are closely related but work in different ways within the body. Anticoagulants inhibit clotting, while antiplatelets inhibit platelets the cause clumping. Both these drugs are classified under antithrombotic drugs.
Some of the common antiplatelets are clopidogrel, ticagrelor, prasugrel, dipyridamole, aspirin, ticlopidine.
Antiplatelets are the group of medicines that prevent blood cells from forming blood clots. When the body gets injured, the body sends platelets to the affected area to form a clot. This prevents death by bleeding. This is a very helpful mechanism. But, at times, the platelets clump together inside the blood vessels that may be injured, or inflamed. Blood clots are also likely to form around stents, artificial heart valves, and other devices that are placed in the heart or blood vessels. Antiplatelet medicines are used to stop clots from forming around these areas. Antiplatelet therapy is used for patients with coronary artery disease, heart attack, angina, peripheral vascular disease, atrial fibrillation, valve disease.
Bleeding that occurs in the brain is referred to as cerebral hemorrhage. Intracranial hemorrhage is the bleeding that occurs inside the skull. It is a life-threatening condition and needs immediate attention. The symptoms include a sudden, severe headache, mild-long lasting headaches, confusion, drowsiness, seizure. It is usually diagnosed by CT scans. Steroid, anti-seizure medicines, anticoagulants are used during the treatment of intracranial hemorrhage.
The use of anticoagulants and antiplatelet drugs pose a clinical challenge to doctors in patients with acute intracerebral hemorrhages. Patients who have suffered hemorrhage and are on the long-term use of anticoagulant therapy run a risk of thrombosis.
Intracerebral hemorrhage can be kept under control by treating high blood pressure or heart disease, maintaining a healthy lifestyle, refraining from drinking or smoking, and keeping diabetes under control. Managing blood pressure is an important factor while treating acute intracerebral hemorrhage.
The decisions to resume anticoagulation in patients is affected by several factors like the location or size of the hemorrhage, rate of recurrence, social factors etc. The decision to resume anticoagulation is made for patients who have lower risk of rebleeding.