Introduction: The relationship between antithrombotic therapy and the anatomical location of acute brain hematoma remains disputed. The current study was therefore designed to address this issue.
Methods: The medical records and CT images were retrospectively reviewed in 484 consecutive patients with an acute brain hemorrhage (291 men, 193 women; mean age, 67.2+/-12.3 years) who were admitted to the hospital within 7 days of stroke onset from January 1999 through October 2003. Antithrombotic therapy had been performed in 116 patients (AT Group): warfarin (n=38), antiplatelet therapy (n=70), or both (n=8). The other 368 patients had not received antithrombotic therapy (non-AT Group). The hematoma location was compared among the groups.
Results: The location of the hematoma was significantly different between the two groups (p<0.0001). The following locations were seen more frequently in the AT Group than in the non-AT Group: thalamic hemorrhage (44.8% vs. 30.7%), cerebellar hemorrhage (7.8% vs. 2.7%), and lobar hemorrhage (18.1% vs. 11.4%). The clinical characteristics in patients with thalamic, cerebellar, or lobar hemorrhage were compared with those with putaminal hemorrhage. A multivariate analysis using the logistic regression model showed that antithrombotic therapy was an independent factor for cerebellar hemorrhage (OR 3.66, 95%CI 1.31-10.18), lobar hemorrhage (OR 2.27, 95%CI 1.12-4.57), and thalamic hemorrhage (OR 2.20, 95%CI 1.06-4.54) in comparison to putaminal hemorrhage.
Conclusions: It therefore appears that antithrombotic therapy is independently associated with thalamic, cerebellar, and lobar hemorrhage.