Abstract
Increasing use of warfarin for primary or secondary prevention of ischaemic
stroke has led to an increased incidence of warfarin-induced intracerebral
haemorrhage (WICH) in recent years. Patients on warfarin have a higher
likelihood of having intracerebral haemorrhage, and the morbidity and
mortality of WICH are higher than for spontaneous intracerebral
haemorrhage. Focal neurological signs in an anticoagulated patient—
especially if accompanied by altered consciousness, headache, nausea and
vomiting—warrant an urgent brain computerised tomography (CT) scan.
WICH is a medical emergency and patients can deteriorate very rapidly.
Warfarin reversal should therefore start as soon as possible, as any delay can
have catastrophic consequences. Infusion of prothrombin complex
concentrates together with intravenous vitamin K is the current
recommended treatment for reversal of the anticoagulant effect of
warfarin in WICH. The aim of this paper is to increase the awareness of
nursing staff regarding this medical emergency and its management