Intracranial Hemorrhage due to Long-term Anticoagulant Therapy in Patients with Prosthetic Heart Valves : Four Case Reports
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概要
- 論文の詳細を見る
Four patients with prosthetic heart valves suffered intracranial hemorrhage (cerebral hemorrhage in one patient, cerebellar hemorrhage in one, and chronic subdural hematoma in two) during long-term oral anticoagulant drug therapy (warfarin). In all patients, warfarin was discontinued and its effect neutralized by vitamin K, then surgery was performed after the thrombotest value exceeded 50%. No uncontrollable bleeding occurred at surgery. Warfarin was discontinued until 3-7 days postoperatively. Intravenous heparin administration was used to prevent embolic complications and the dose was modified based on the activated clotting time measured at the bedside. One patient, who could not receive heparin administration because of massive bleeding, developed myocardial infarction due to coronary artery thromboembolism 2 days after operation and died 4 days later. The other patients received heparin administration and were alive and well at the most recent follow-up examinations. Heparin administration monitored by activated clotting time is a useful method to prevent embolic and bleeding complications in the surgical treatment of intracranial hemorrhage in patients with prosthetic heart valves receiving long-term anticoagulant therapy.
- 日本脳神経外科学会の論文
- 1995-03-15
著者
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KAWANO Hirokazu
Department of Neurosurgery, Miyazaki Prefectural Hospital
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Sato Kazufumi
Department Of Neurosurgery Faculty Of Medical Sciences University Of Fukui
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KUBOTA Toshihiko
Department of Neurosurgery, University of Fukui
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NAKAGAWA Takao
Department of Infrared Astrophysics, Institute of Space and Astronautical Science (ISAS), Japan Aero
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Nakagawa Takao
Department Of Emergency Medicine Tokyo Women's Medical University Daini Hospital
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Nakagawa Takao
福井医科大学脳神経外科
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Kubota Toshihiko
Department Of Neurosurgery Faculty Of Medical Sciences University Of Fukui
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Kubota Toshihiko
Department Of Neurosurgery Fukui Medical School
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Kubota Toshihiko
Department Of Neurosurgery Kaga Central Hospital
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Nakagawa Takao
Department Of Neurosurgery Faculty Of Medical Sciences University Of Fukui
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Kawano Hirokazu
Department Of Neurosurgery Fukui Medical School
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Sato K
Department Of Neurosurgery Faculty Of Medical Sciences University Of Fukui
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Handa Yuji
Department of Neurosurgery, Fukui Medical University
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Kodera Toshiaki
Department Of Neurosurgery Sugita Genpaku Memorial Obama Municipal Hospital
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Handa Yuji
Division Of Neurosurgery Department Of Sensory & Locomotor Medicine Faculty Of Medical Science U
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Handa Yuji
Department Of Neurosurgery Fukui Medical School
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Kubota Toshihiko
Department Of Internal Medicine Kitasato University School Of Medicine
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Handa Yuji
Division Of Neurosurgery Department Of Sensory & Locomotor Medicine Faculty Of Medical Science U
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Kubota Toshihiko
Department Of Neurosurgery Sugita Genpaku Memorial Obama Municipal Hospital
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KAWANO Hirokazu
Department of Neurosurgery, Fukui Medical School
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