Abstract
Patients on oral anticoagulants are at risk of intracerebral hemorrhage (ICH), and have larger hematomas compared to patients without coagulopathy. Mortality in these patients exceeds 50 %, likely due to hematoma expansion. Although quality, high-level evidence from randomized controlled trials is lacking, current guidelines recommend replacement of vitamin K-dependent factors and correction of INR with vitamin K, fresh-frozen plasma (FFP), or prothrombin complex concentrates (PCC) immediately to prevent hematoma expansion. Intensive blood pressure reduction may also improve clinical outcomes.