Anticoagulation/antiplatelet reversal in intraparenchymal hemorrhage

DDAVP
In one retrospective study of 124 patients on antiplatelets (73% ASA, 19% dual antiplatelets, and 9% Plavix), 55 of whom received DDAVP and 69 of whom did not, DDAVP was associated with a lower likelihood of at least 3 mL IPH expansion within the first 24 hours (OR 0.22, 95% CI 0.08-0.57). There was no significant decrease in serum sodium, and no statistically significant difference in thrombotic events although they occurred in 7.3% of DDAVP patients and 1.4% of non-DDAVP patients (p=.0.170).

Warfarin
In intraparenchymal hemorrhage for patients on warfarin with INR >1.4, reversal of anticoagulation with prothrombin complex concentrate (PCC) or fresh frozen plasma (FFP) is a Neurocritical Care Society Clinical Performance Measure.