Question

A 70-year-old man on long-term warfarin for mechanical aortic valve presents with sudden severe headache and vomiting. CT brain shows a large intracerebral haemorrhage. His INR is 4.2. What is the MOST appropriate immediate strategy for reversal of anticoagulation?

Accepted Answer

Give 4-factor prothrombin complex concentrate plus intravenous vitamin K

Answer

Stop warfarin and observe; no specific reversal required

Answer

Give intravenous vitamin K alone

Answer

Transfuse fresh frozen plasma alone

Answer

Switch warfarin to a direct oral anticoagulant without reversal

Practice question

A 70-year-old man on long-term warfarin for mechanical aortic valve presents with sudden severe headache and vomiting. CT brain shows a large intracerebral haemorrhage. His INR is 4.2. What is the MOST appropriate immediate strategy for reversal of anticoagulation?