Faut-il continuer à prendre en charge les accidents hémorragiques des AVK en neurochirurgie ?

The OAC treatment is considered a hemorrhagic factor, with or without overdose, especially associated with old age and trauma. Surgical management of intracerebral hematoma seems useless, even though medical treatment has equal outcome. On the other hand, acute subdural hematomas, with an initial Glasgow score less than 11, showed improved outcome with surgery in one case of three. A diagnostic cerebral angiography remains systematic in case of a meningeal hemorrhage to find a potential aneurism. Spinal hemorrhages have the worst functional outcome, but surgery seems to be necessary for ethical reasons. Finally, of the 98 patients, 64 (65%) needed neurosurgery management.