Anticoagulation for prevention of cerebral infarcts following subarachnoid hemorrhage

Document Type

Article

Abstract

BACKGROUND: Late neurologic deterioration following subarachnoid hemorrhage is often due to vasospasm and rebleeding. Although the sudden onset of a focal neurologic deficit can actually be the result of thromboembolism, anticoagulation has rarely been used in such cases. METHODS: We report a case of a 55-year-old woman who developed recurrent transient focal neurologic deficits 13 days after having a subarachnoid hemorrhage, with multiple cerebral infarcts by CT. Two cerebral angiograms showed no aneurysm. Her symptoms and clinical temporal profile were consistent with thromboembolic phenomenon. We elected to treat her with systemic anticoagulation. RESULTS: The patient had no recurrent events after systemic anticoagulation, but had episodic sensory changes and a new infarct on MRI once the anticoagulation was discontinued. CONCLUSIONS: Anticoagulant was safely administered after subarachnoid hemorrhage (SAH) in this patient and may have been effective in preventing further cerebral ischemic infarction following her SAH. Our patient's clinical profile of sudden (rather than gradual) onset of a transient focal neurologic deficit and resolution of blood on CT indicates one setting in which the use of heparin may be considered.

Medical Subject Headings

Anticoagulants (therapeutic use); Cerebral Infarction (diagnosis, etiology, prevention & control); Female; Humans; Magnetic Resonance Imaging; Middle Aged; Subarachnoid Hemorrhage (complications, diagnosis); Tomography, X-Ray Computed

Publication Date

9-1-1995

Publication Title

Surgical neurology

ISSN

0090-3019

Volume

44

Issue

3

First Page

270

Last Page

4

PubMed ID

8545780

Digital Object Identifier (DOI)

10.1016/0090-3019(95)00142-5

Link to Full Text

Share

COinS