INTRODUCTION: In patients with non-aneurysmal perimesencephalic hemorrhage, spontaneous rebleeding does not occur. The lack of reported recurrences may lead to less cautious administration of antithrombotic therapy. METHODS: Case report. RESULTS: A 57-year-old woman with a perimesencephalic pattern of hemorrhage and negative CT angiography was treated with carbasalate calcium and intravenous heparin because of an acute coronary syndrome. Three days after installment of this antithrombotic therapy she experienced a recurrent perimesencephalic hemorrhage leading to hydrocephalus and a decrease in consciousness. She died the same day as a result of ventricular fibrillation. CONCLUSION: In the early phase after perimesencephalic hemorrhage, anticoagulant therapy may lead to rebleeding. The risks and benefits of antithrombotic therapy should be carefully weighed in patients with a perimesencephalic pattern of hemorrhage and negative CT angiography.
INTRODUCTION: In patients with non-aneurysmal perimesencephalic hemorrhage, spontaneous rebleeding does not occur. The lack of reported recurrences may lead to less cautious administration of antithrombotic therapy. METHODS: Case report. RESULTS: A 57-year-old woman with a perimesencephalic pattern of hemorrhage and negative CT angiography was treated with carbasalate calcium and intravenous heparin because of an acute coronary syndrome. Three days after installment of this antithrombotic therapy she experienced a recurrent perimesencephalic hemorrhage leading to hydrocephalus and a decrease in consciousness. She died the same day as a result of ventricular fibrillation. CONCLUSION: In the early phase after perimesencephalic hemorrhage, anticoagulant therapy may lead to rebleeding. The risks and benefits of antithrombotic therapy should be carefully weighed in patients with a perimesencephalic pattern of hemorrhage and negative CT angiography.
Authors: L Gerard Toussaint; Jonathan A Friedman; Eelco F M Wijdicks; David G Piepgras; Mark A Pichelmann; Jon I McIver; Robyn L McClelland; Douglas A Nichols; Fredric B Meyer; John L D Atkinson Journal: J Neurosurg Date: 2004-12 Impact factor: 5.115
Authors: Matthew L Flaherty; Mary Haverbusch; Brett Kissela; Dawn Kleindorfer; Alexander Schneider; Padmini Sekar; Charles J Moomaw; Laura Sauerbeck; Joseph P Broderick; Daniel Woo Journal: J Stroke Cerebrovasc Dis Date: 2005 Nov-Dec Impact factor: 2.136
Authors: Ning Lin; Georgios Zenonos; Albert H Kim; Stephen V Nalbach; Rose Du; Kai U Frerichs; Robert M Friedlander; William B Gormley Journal: Neurocrit Care Date: 2012-06 Impact factor: 3.210