Hemophilia Drug May Slow Intracerebral Hemorrhage

New recommendations include using MRI in diagnosis and postponing do-not-resuscitate orders for 24 hours

FRIDAY, May 4 (HealthDay News) -- Recombinant activated factor VII (rFVIIa) may help slow bleeding if given within four hours of an intracerebral hemorrhage, although more study is needed before it's used outside of a clinical trial, according to new treatment guidelines from the joint councils of the American Heart Association/American Stroke Association. The guidelines were published online May 3 in Stroke: Journal of the American Heart Association.

Joseph Broderick, M.D., chair of the guideline writing committee, and his colleagues provide an update to guidelines issued in 1999 that are based on 15 newer studies that have been completed or are ongoing.

While routine surgical treatment is not recommended, it may be appropriate in some cases, including patients with larger clots close to the brain's surface. Magnetic resonance imaging (MRI) is now included with computed tomography as first-choice imaging options, with each having unique benefits. The guidelines also suggest postponing do-not-resuscitate orders within the first 24 hours of intracerebral hemorrhage.

The committee notes that the use of rFVIIa within four hours after the onset of hemorrhage may help slow bleeding. "rFVIIa is mentioned as a potential new treatment that needs confirmation," Broderick said in a statement. "The efficacy and safety of this treatment must be established in an ongoing phase III trial before its use in patients with intracerebral hemorrhage can be recommended outside of a clinical trial."

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