Keep MAP <130 during acute phase
When patient is anticoagulated on warfarin with INR > 2.0 should consider reversal with following:
Vitamin K 10mg IV (small risk of anaphylaxis, takes up to 6 hours to work)
FFP (generally need up to 6 units to bring INR to 1.2; careful about volume overload in the elderly)
Prothrombin Complex Concentrate (25-50mg/kg IV)
very expensive with limited data but trends are moving towards using this in life threatening bleeding. can decrease hematoma expansion.
Desmopressin: can increase activity of platelets via vWF
Arabinda Pani, MD