Significance of the fluid-blood interface in intracranial hematomas in anticoagulated patients

Six patients receiving anticoagulant medication who had laboratory evidence of impaired hemostasis as manifested by laboratory parameters exceeding the therapeutic range developed intracranial hemorrhages. None of these patients had a history of preceding trauma. None of the 6 anticoagulated had CNS symptoms prior to inititation of anticoagulant medication. Within the intracranial hemorrhage there was a fluid-blood interface in these 6 patients; this finding was seen only in hemorrhages in anticoagulated patients. In 3 cases the fluid-blood interface changed to a homogeneous hyperdense lesion when adequate hemostasis was achieved. In one case there were multiple hemorrhages and in the other there was a solitary intracerebral hemorrhage.