Warfarin是一個vitamin K的拮抗物，可以有效抑制肝臟製造的凝血因子，臨床常用於心房纖維顫動、靜脈血栓性栓塞和置換機械性心臟瓣膜之患者，而腦出血是使用warfarin最常見的嚴重副作用。本案例為一位55歲女性，本身有腦動靜脈畸型，又因風濕性心臟病接受機械性心臟瓣膜置換術而需長期服用warfarin，此次發生腦出血疑似與warfarin相關。住院期間雖然給予vitamin K和新鮮冷凍血漿（fresh frozen plasma, FFP），欲反轉其INR數值，但仍無法改善病人預後。文中藉由此案例探討並回顧文獻如何處理warfarin所引起腦出血並預防再次發生，提供未來治療之參考。
 

Warfarin, vitamin K antagonist, is effective in preventing the hepatic production of clotting factors. Common clinical indications for warfarin use are atrial fibrillation, venous thromboembolism and mechanical heart valve replacement. Intracerebral hemorrhage is the most common serious adverse effect associated with warfarin therapy. A case of 55-year-old female who underwent mechanical heart valve replacement for rheumatic heart disease was under long-term warfarin therapy. This patient has an arterio-venous malformation. This time we suspected that arterio-venous malformation hemorrhage was due to warfarin. Vitamin K and fresh frozen plasma were prescribed to reverse the INR, but it was not able to achieve better outcome for patient. In this article, we reviewed literature about the treatment and the prevention of warfarin-associated intracerebral hemorrhage.