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Death or dependency aft SAH occurred in 14 of 15 patients on anticoagulant treatment and 62 of 126 patients not being treated with anticoagulants (relative risk,1.9,95%confidence interval,1.5 to 2.4).The patients on treatment with anticoagulants were more often comatose on admission;the frequency of rebleeding,secondary ischemia,and hydrocephalus were not higher in patients on anticoagulants.In the stratified analysis,the worse outcome in the group of anticoagulant drugs was not essentially influenced by difference in sex,age,cardiovascular history,site of aneurysm,amount of cisternal blood,or extension of hemorrhage into the ventricles.The outcome of aneurysmal SAH in patients on anticoagulant drugs is extremely poor.The explanation for the worse prognosis in patients on anticoagulants lies in a worse clinical condition from the outset.The poor outcome urges a reconsideration of the balance of risks for anticoagulant treatment in patients with an unoperated intracranial aneurysm or with a family history of SAH and my lead to withholding treatment with anticoagulant drugs or to a preventive operation. |
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adverse drug reaction
aneurysm
aneurysm,intracranial
anticoagulant,complications of
anticoagulant,treatment
subarachnoid hemorrhage
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