Nine studies (n=2,043) were included: eight RCTs and one double-blind comparative trial, which did not provide sufficient information to assess whether the treatment allocation was randomised. Data were also reported from two observational studies, although these were not included in the pooling.
Antiplatelet treatment.
In patients with any form of acute intracranial haemorrhage (8 studies; n=1,997), compared with placebo, the likelihood of death was similar for patients allocated to antiplatelet treatment (OR 0.85, 95% CI: 0.63, 1.15) and also for recurrent intracranial haemorrhage (OR 1.00, 95% CI: 0.73, 1.37).
In patients with intraparenchymal cerebral haemorrhage (2 studies, n=773), compared with the control condition, the likelihood of death was similar for patients allocated to antiplatelet treatment (OR 0.96, 95% CI: 0.62, 1.50) and for recurrent intracranial haemorrhage (OR 1.02, 95% CI 0.58, 1.8). For functional outcome (i.e. being dead or dependent) (1 study, n=599), there was no significant difference for patients receiving antiplatelet treatment compared with the control condition (OR 0.68, 95% CI: 0.46, 1.02).
Anticoagulant treatment.
In patients with intraparenchymal cerebral haemorrhage (2 studies; n=645), compared with the control condition, the likelihood of death was similar for patients allocated to anticoagulant treatment (OR 0.96, 95% CI: 0.38, 2.40) while the likelihood of recurrent intracranial haemorrhage was higher for patients receiving anticoagulant treatment (OR 2.0, 95% CI: 0.86, 4.70, P=0.11). For functional outcome (i.e. being dead or dependent) (1 study, n=599), there was no significant difference for patients receiving antiplatelet treatment compared with the control condition (OR 0.97, 95% CI: 0.66, 1.43).