|Principal Investigator: JenniferMajersik|
|Keywords: Coumadin , Hemorrhegic Stroke , Genetic analysis , Control||Department: Neurology|
|IRB Number: 00044852||Co Investigator:|
|Sub Specialties: Stroke|
The purpose of this research study is to identify genetic or inherited factors that may increase the risk of bleeding in the brain (hemorrhagic stroke) for people who are taking warfarin, a drug that thins a person’s blood. We hope to use the results of this study to find a better ways to predict who is at increased risk for bleeding in the brain while taking warfarin so that doctors can take this into account when deciding how to prescribe the drug.
Patients counted in the case cohort must have symptomatic ICH, sufficiently severe to cause the patient to seek medical attention. Age >55. Ability and willingness of patient, family member, or legal guardian to provide informed consent.
Patient taking warfarin (for any indication) at the time of ICH with INR at presentation > 1.4 are classified as warfarin-exposed.
Inclusion criteria for participants in the control group are the same as those indicated above for ICH patients, with the exception that subjects will not have had symptomatic ICH.
Patients counted in the case cohort will be excluded for the following reasons:
1. Patient taking heparin (for any indication) at the time of ICH.
2.Concussive head trauma during the 24 hours before ICH presentation (unless trauma was clearly a result of the ICH, e.g. head trauma resulting from a seizure caused by acute ICH)
3.Radiographic or pathological demonstration of any of the following
a.ischemic stroke, occurring during the 2 weeks prior
to ICH presentation
b. primary or metastatic intracerebral tumor
c. intracerebral vascular malformation
d. vasculitis of the central nervous system
4. Antecedent use of cocaine or sympathomimetic drug
5. Antecedent alcohol abuse (defined as >8 drinks in the previous 24 hours or >28 drinks over the previous week)
6. History of a primary coagulopathy, blood dyscrasia, or active liver disorder
7. Greater than 1 week interval between onset of symptoms and presentation to enrolling center
Patients counted in the control cohort will be excluded for the following reasons:
1. History of symptomatic ICH
2. Initial INR at presentation <1.4
3. Antecedent use of cocaine or sympathomimetic drug
4. Antecedent alcohol abuse (defined as >8 drinks in the previous 24 hours or >28 drinks over the previous week)
5. History of a primary coagulopathy, blood dyscrasia, or active liver disorder