Reactions 1704, p373 - 2 Jun 2018 Lobar intracerebral haemorrhage: case report An 86-year-old woman developed lobar intracerebral haemorrhage during treatment with warfarin [coumadin; dosage, route, time to reaction onset and outcome not stated]. The woman had a history of multiple deep vein thrombosis and heterozygous for Factor V Leiden and prothrombin gene mutations. She had been receiving anticoagulation therapy with warfarin. She presented to the emergency department with right arm weakness and aphasia. She was found to have intracerebral haemorrhage with intraventricular extension as revealed by head CT. The woman received prothrombin complex concentrate [Kcentra] to reverse anticoagulation. An MRI revealed approximately 50 micro-bleeds with primarily lobar distribution, consistent with underlying cerebral amyloid angiopathy. Lower extremity non-invasive study showed a non-occlusive thrombus in the left femoral and popliteal veins. The treatment with warfarin was discontinued due to the high risk of recurrent intracranial haemorrhage. She was initiated on prophylactic dosing of enoxaparin sodium [lovenox]. Author comment: "Case presentation of lobar intracerebral haemorrhage in a patient with inherited hyper- coagulable state on systemic anticoagulation with underlying CAA." Li M, et al. The complex dilemma- Decision for anticoagulation in cerebral amyloid angiopathy (CAA) with microbleeds. Journal of the American Geriatrics Society 66 (Suppl. 2): S181, Apr 2018. Available from: URL: http:// doi.org/10.1111/jgs.15376 [abstract] - USA 803323396 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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