Compared with vitamin K antagonist (VKA)-related non-traumatic intracerebral hemorrhage (ICH), direct oral anticoagulant (DOAC)-related ICH had less disability, smaller bleeds, and the meta-analysis showed lower in-hospital mortality rates.
Elderly stroke patients over age 80 who received tPA >3 – 4.5 hours from time of onset were more likely to have symptomatic intracranial hemorrhage (SICH), 10% vs 8% in the <3-hour group, but overall mortality and percentage with good neurological outcome was the same in the delayed group as patients who received it in under 3 hours.
The NEXUS criteria can be used to determine which patients do not need c-spine x-rays. Since this was published, we have shifted to predominantly CT imaging, which is more sensitive. Also, we have learned that NEXUS is not as sensitive in elderly patients.