Research Article

Risk Assessment Of Coumadin-related Intracranial Hemorrhage Via Magnetic Resonance Imaging In Patients With Ischemic Stroke

  • F. İrsel Tezer
  • Murat Arsava
  • Adeviye Gökoğlu
  • Erdem Karabulut
  • Hakan Ay
  • Okay Sarıbaş

Received Date: 30.08.2007 Accepted Date: 05.05.2008 J Ankara Univ Fac Med 2008;61(1):13-24


The risk of intracerebral hemorrhage is increased to 8-11 fold, especially in patients with ischemic stroke. Gradient echo magnetic resonane imaging (GE-MRI) is able to show microhemorrhages. In that study, relationship between the frequency of microhemorrhage foci and treatment was investigated.


The changes of microhemorrhages in patients having anticoagulant or antiaggregant drugs due to ischemic stroke were followed with GE-MRI in six moths interval. The clinical and MRI findings were also revealed. The first and second MRIs of 37 patients were compared. The first MRI findings of these patients and 26 patients who had no sixth month MRI were evaluated as first MRIs.


Micohemorrhages were documented in the 60% of 63 patients in the first MRIs. The frequency was found to be increased with age, presence of lacuner infarction and moderate to severe leukoariosis. An increase of microhemorrhages was seen in the 14 of 37 patients in the six month follow-up, but there were no statistically significant impact of treatment, MRI findings and other risk factors.


The study pointed out the GE-MRI seems to be a pivotal role in the assessment of the risk of intracranial hemorrhage in patients with ischemic stroke especially with advanced age, leukoariosis and lacuner infarction.

Keywords: microhemorrhage, leukoariosis, ischemic stroke, gradient echo MRI, coumadin