Chen XT, Zhang Q, Zhou CQ, Han YF, Cao QQ. Anticoagulant treatment for pulmonary embolism in patient with cerebral hemorrhage secondary to mechanical thrombectomy: A case report. World J Clin Cases 2021; 9(33): 10279-10285 [PMID: 34904100 DOI: 10.12998/wjcc.v9.i33.10279]
Corresponding Author of This Article
Chang-Qing Zhou, MD, Chief Doctor, Department of Neurology, Bishan Hospital, First Affiliated Hospital of Chongqing Medical University, Shuangxing Road No.9, Bishan District, Chongqing 402760, China. changqing_zhou@163.com
Research Domain of This Article
Clinical Neurology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 26, 2021; 9(33): 10279-10285 Published online Nov 26, 2021. doi: 10.12998/wjcc.v9.i33.10279
Anticoagulant treatment for pulmonary embolism in patient with cerebral hemorrhage secondary to mechanical thrombectomy: A case report
Xiang-Ting Chen, Qian Zhang, Chang-Qing Zhou, Yu-Fu Han, Qing-Qing Cao
Xiang-Ting Chen, Qian Zhang, Chang-Qing Zhou, Yu-Fu Han, Qing-Qing Cao, Department of Neurology, Bishan Hospital, First Affiliated Hospital of Chongqing Medical University, Chongqing 402760, China
Author contributions: Chen XT, Zhang Q, Zhou CQ, Cao QQ, and Han YF diagnosed, treated, and followed up the patient; Chen XT and Zhou CQ drafted the manuscript and created the figures; Zhou CQ and Zhang Q contributed to the revision of the manuscript; Zhou CQ and Han YF were involved in the surgery; All authors have read and approved the final manuscript to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chang-Qing Zhou, MD, Chief Doctor, Department of Neurology, Bishan Hospital, First Affiliated Hospital of Chongqing Medical University, Shuangxing Road No.9, Bishan District, Chongqing 402760, China. changqing_zhou@163.com
Received: May 24, 2021 Peer-review started: May 24, 2021 First decision: June 25, 2021 Revised: July 8, 2021 Accepted: August 19, 2021 Article in press: August 19, 2021 Published online: November 26, 2021 Processing time: 181 Days and 18 Hours
Abstract
BACKGROUND
Cerebral hemorrhage secondary to cerebral embolism after mechanical thrombectomy is characterized by high morbidity, disability and mortality. If the patient also has severe pulmonary embolism (PE) at the same time, the treatment becomes more complex. This report describes the treatment strategy for a patient with PE and cerebral hemorrhage secondary to cerebral embolism after mechanical thrombectomy.
CASE SUMMARY
A 70-year-old woman presented to our emergency department with right-sided hemiplegia and mixed aphasia of 2.5 h duration. She was diagnosed with left cerebral embolism, left internal carotid artery occlusion, PE and left calf intramuscular vein thrombosis. Following mechanical thrombectomy, brain magnetic resonance imaging showed cerebral infarction with basal ganglia hemorrhage. We observed changes in cerebral hemorrhage on serial monitoring of brain computed tomography and adjusted the dose of anticoagulant drugs. After 3 wk of treatment, the patient’s neurological and respiratory symptoms significantly improved, and a favorable prognosis was obtained.
CONCLUSION
Anticoagulation could be a potential option for PE accompanied by hemorrhagic transformation of an ischemic infarct.
Core Tip: Pulmonary embolism accompanied by cerebral hemorrhage secondary to cerebral embolism after mechanical thrombectomy is characterized by high disability and mortality. To manage this situation, we adopted a treatment strategy that involved adjustment of anticoagulant drugs according to the changes in cerebral hemorrhage after mechanical thrombectomy. The patient had a favorable prognosis.
