RSS-Feed abonnieren

DOI: 10.1055/s-0035-1564827
Uso de fator protrombínico no tratamento de hematoma subdural espontâneo: relato de caso
Prothrombin Factor Use in the Treatment of Spontaneous Subdural Haematoma: Case ReportPublikationsverlauf
09. Mai 2013
07. August 2015
Publikationsdatum:
03. November 2015 (online)

Resumo
A warfarina é amplamente utilizada na condução de pacientes com patologias cardiovasculares, apesar do risco de sangramentos potencialmente graves. Quando tais sangramentos ocorrem, é necessária rápida reversão da anticoagulação. No presente relato descreve-se um paciente que desenvolveu hematoma subdural espontâneo associado ao uso de warfarina, necessitando intervenção cirúrgica emergencial. É dada ênfase aos mecanismos de produção deste fenômeno e à sua condução clínica.
Abstract
Warfarin is widely used on the treatment of cardiovascular pathology, although there are risks of potentially lethal bleeding. When such bleeding occurs, it is imperative a rapid reversal of anticoagulation. A case of a spontaneous subdural hematoma during the use of warfarin and requiring emergent surgical treatment is reported. Emphasis is given to the mechanisms of this phenomenon and its clinical conduction.
-
Referências
- 1 Hart RG, Boop BS, Anderson DC. Oral anticoagulants and intracranial hemorrhage. Facts and hypotheses. Stroke 1995; 26 (8) 1471-1477
- 2 Schulman S, Beyth RJ, Kearon C, Levine MN ; American College of Chest Physicians. Hemorrhagic complications of anticoagulant and thrombolytic treatment: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008; 133 (6, Suppl) 257S-298S
- 3 Gilad R, Fatterpekar GM, Johnson DM, Patel AB. Migrating subdural hematoma without subarachnoid hemorrhage in the case of a patient with a ruptured aneurysm in the intrasellar anterior communicating artery. AJNR Am J Neuroradiol 2007; 28 (10) 2014-2016
- 4 Talalla A, McKissock W. Acute “spontaneous” subdural hemorrhage. An unusual form of cerebrovascular accident. Neurology 1971; 21 (1) 19-25
- 5 Chhiber SS, Singh JP. Acute spontaneous subdural hematoma of arterial origin: a report of four cases and review of literature. Neurol India 2010; 58 (4) 654-658
- 6 Agrawal D, Mahapatra AK. Spontaneous subdural hematoma in a young adult with hemophilia. Neurol India 2003; 51 (1) 114-115
- 7 Alves OL, Gomes O. Cocaine-related acute subdural hematoma: an emergent cause of cerebrovascular accident. Acta Neurochir (Wien) 2000; 142 (7) 819-821
- 8 Gelabert-González M, Fernández-Villa JM, Iglesias-Pais M, González-García J, García-Allut A. Hematoma subdural agudo espontâneo de origen arterial. Neurocirurgía 2004; 15: 165-170
- 9 Teles JS, Fukuda EY, Feder D. Warfarin: pharmacological profile and drug interactions with antidepressants. Einstein (Sao Paulo) 2012; 10 (1) 110-115
- 10 Bruce D, Nokes TJ. Prothrombin complex concentrate (Beriplex P/N) in severe bleeding: experience in a large tertiary hospital. Crit Care 2008; 12 (4) R105
- 11 Schick KS, Fertmann JM, Jauch KW, Hoffmann JN. Prothrombin complex concentrate in surgical patients: retrospective evaluation of vitamin K antagonist reversal and treatment of severe bleeding. Crit Care 2009; 13 (6) R191
- 12 Arnékian V, Camous J, Fattal S, Rézaiguia-Delclaux S, Nottin R, Stéphan F. Use of prothrombin complex concentrate for excessive bleeding after cardiac surgery. Interact Cardiovasc Thorac Surg 2012; 15 (3) 382-389
- 13 Imberti D, Barillari G, Biasioli C , et al. Emergency reversal of anticoagulation with a three-factor prothrombin complex concentrate in patients with intracranial haemorrhage. Blood Transfus 2011; 9 (2) 148-155
- 14 Chaves DG, Rodrigues CV. Desenvolvimento de inibidores do fator VIII na hemofilia A. Rev Bras Hematol Hemoter. 2009; 31 (5) 384-390
- 15 H-y CS, Xuemei C , G KR, et al. Thromboembolic risks of recombinant factor VIIa Use in warfarin-associated intracranial hemorrhage: a case-control study. BMC Neurol 2012; 12: 158
- 16 Fredriksson K, Norrving B, Strömblad LG. Emergency reversal of anticoagulation after intracerebral hemorrhage. Stroke 1992; 23 (7) 972-977
- 17 Akioka N, Fukuda O, Takaba M, Kameda H, Saito T, Endo S. Clinical investigation of acute spontaneous subdural hematoma cases. J Stroke Cerebrovasc Dis 2007; 16 (3) 109-113
- 18 Chandra D, Gupta A, Grover V, Kumar Gupta V. When should you restart anticoagulation in patients who suffer an intracranial bleed who also have a prosthetic valve?. Interact Cardiovasc Thorac Surg 2013; 16 (4) 520-523