Significance of antiplatelet therapy after spontaneous intracerebral hemorrhage and hemorrhagic transformation
10.3760/cma.j.cn113694-20250111-00021
- VernacularTitle:再论自发性脑出血和出血转化后的抗血小板治疗
- Author:
Dawei CHEN
1
;
Jin SHI
1
Author Information
1. 空军特色医学中心神经内科，北京 100142
- Publication Type:Journal Article
- Keywords:
Intracerebral hemorrhage;
Spontaneous;
Hemorrhagic transformation;
Antiplatelet therapy;
Platelet reactivity
- From:
Chinese Journal of Neurology
2025;58(6):585-590
- CountryChina
- Language:Chinese
-
Abstract:
Whether in cases of spontaneous intracerebral hemorrhage (ICH) or hemorrhagic transformation (HT) after acute ischemic stroke, initiating antiplatelet therapy (APT) is relatively safe when blood pressure is effectively controlled. APT should be actively initiated for all eligible patients with appropriate indications. For spontaneous ICH patients, the timing of APT resumption can range from 24 hours to 30 days after hemorrhage, depending on the patients′ bleeding and thrombotic risks. For hemorrhagic infarction-type HT, APT may be continued. For parenchymal hematoma-type HT, APT can be restarted 2-4 weeks later, based on the size of the cerebral infarction and the extent of hemorrhage. After ICH, monotherapy with conventional antiplatelet agents is generally recommended. The choice of antiplatelet drug and dosage may be guided by platelet function testing and pharmacogenomic analysis.
