CC BY 4.0 · J Neuroanaesth Crit Care
DOI: 10.1055/s-0044-1787195
Case Report
1 Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India , 1 Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India , Suman Sokhal 1 Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India , Arvind Chaturvedi 1 Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India
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Abstract
Deep vein thrombosis (DVT) is a known complication of aneurysmal subarachnoid hemorrhage (aSAH), and anticoagulant therapy is crucial for its management. However, in case of a ruptured intracranial aneurysm in a patient of DVT, anticoagulant administration may lead to rebleeding. Anticoagulants are also associated with a risk of hematoma expansion. A systematic approach is required to weigh the risk and benefit ratio while managing such cases. We report the successful management of a 61-year-old female presenting with aSAH and associated DVT who had an intracranial vessel injury during intraoperative clipping of an aneurysm.
Keywords
anticoagulation - subarachnoid hemorrhage - deep vein thrombosis
Publication History
Article published online:
18 June 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 de Rooij NK, Linn FH, van der Plas JA, Algra A, Rinkel GJ. Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends. J Neurol Neurosurg Psychiatry 2007; 78 (12) 1365-1372
- 2 Ray WZ, Strom RG, Blackburn SL, Ashley WW, Sicard GA, Rich KM. Incidence of deep venous thrombosis after subarachnoid hemorrhage. J Neurosurg 2009; 110 (05) 1010-1014
CrossrefPubMedGoogle Scholar
- 3 Hirashima Y, Nakamura S, Endo S, Kuwayama N, Naruse Y, Takaku A. Elevation of platelet activating factor, inflammatory cytokines, and coagulation factors in the internal jugular vein of patients with subarachnoid hemorrhage. Neurochem Res 1997; 22 (10) 1249-1255
- 4 Peltonen S, Juvela S, Kaste M, Lassila R. Hemostasis and fibrinolysis activation after subarachnoid hemorrhage. J Neurosurg 1997; 87 (02) 207-214
CrossrefPubMedGoogle Scholar
- 5 Geraldini F, De Cassai A, Correale C. et al. Predictors of deep-vein thrombosis in subarachnoid hemorrhage: a retrospective analysis. Acta Neurochir (Wien) 2020; 162 (09) 2295-2301
CrossrefPubMedGoogle Scholar
- 6 Liang CW, Su K, Liu JJ, Dogan A, Hinson HE. Timing of deep vein thrombosis formation after aneurysmal subarachnoid hemorrhage. J Neurosurg 2015; 123 (04) 891-896
CrossrefPubMedGoogle Scholar
- 7 NICE. Venous thromboembolic diseases: diagnosis, management and thrombophilia testing. NICE Guideline 158. NICE,; 2020 . Accessed May14, 2024 at: www.nice.org.uk/ng158
PubMedGoogle Scholar
- 8 Goodacre S, Sampson F, Thomas S, van Beek E, Sutton A. Systematic review and meta-analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis. BMC Med Imaging 2005; 5: 6
CrossrefPubMedGoogle Scholar
- 9 Connolly Jr ES, Rabinstein AA, Carhuapoma JR. et al; American Heart Association Stroke Council, Council on Cardiovascular Radiology and Intervention, Council on Cardiovascular Nursing, Council on Cardiovascular Surgery and Anesthesia, Council on Clinical Cardiology. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2012; 43 (06) 1711-1737
- 10 Collen JF, Jackson JL, Shorr AF, Moores LK. Prevention of venous thromboembolism in neurosurgery: a metaanalysis. Chest 2008; 134 (02) 237-249
CrossrefPubMedGoogle Scholar
- 11 Kearon C, Akl EA, Comerota AJ. et al. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141 (02) e419S-e496S
- 12 Steiner T, Juvela S, Unterberg A, Jung C, Forsting M, Rinkel G. European Stroke Organization. European Stroke Organization guidelines for the management of intracranial aneurysms and subarachnoid haemorrhage. Cerebrovasc Dis 2013; 35 (02) 93-112
CrossrefPubMedGoogle Scholar
- 13 Cho WS, Kim JE, Park SQ. et al; Quality Control Committees from the Korean Society of Cerebrovascular Surgeons, Society of Korean Endovascular Neurosurgeons, Korean Society of Interventional Neuroradiology, Korean Stroke Society and Korean Academy of Rehabilitation Medicine. Korean clinical practice guidelines for aneurysmal subarachnoid hemorrhage. J Korean Neurosurg Soc 2018; 61 (02) 127-166
CrossrefPubMedGoogle Scholar
- 14 Wong KC, Boet R, Poon WS, Yu S. Inferior vena caval filters following deep vein thrombosis in patients with ruptured intracranial aneurysm. Hong Kong Med J 2002; 8 (04) 288-290
PubMedGoogle Scholar
- 15 Streiff MB. Vena caval filters: a review for intensive care specialists. J Intensive Care Med 2003; 18 (02) 59-79
CrossrefPubMedGoogle Scholar
