Secondary hematoma expansion in intracerebral hemorrhage during rivaroxaban therapy

作者：Purrucker Jan C^*; Capper David; Behrens Lars; Veltkamp Roland

来源：American Journal of Emergency Medicine, 2014, 32(8): 947.e3.

DOI：10.1016/j.ajem.2014.01.042

Hematoma size is a key prognostic parameter in intracerebral hemorrhage (ICH); hence, secondary hematoma enlargement is an important event. Hematoma enlargement occurs more frequently and over a prolonged period in ICH patients on vitamin K antagonists compared with nonanticoagulated patients. So far, little is known about the natural history of ICH associated with new oral anticoagulants. Here, we present a 76-year-old woman anticoagulated with rivaroxaban who presented with a computed tomography showing a right basal ganglia ICH with ventricular extension. Although prothrombin concentrate was administered to reverse anticoagulation, follow-up cranial computed tomography demonstrated secondary hematoma enlargement. The patient deteriorated and died 10 days after from further rebleeding and consequently withdrawal of life-prolonging therapy. Postmortem examination revealed no specific cause of bleeding.

• 出版日期2014-8