Neurologia i neurochirurgia polska · 2016
Fatal consequences of climbing a ladder under apixaban and drunken.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Stöllberger Claudia, Finsterer Josef
Аннотация
BACKGROUND: Apixaban, a factor-Xa-inhibitor, is one of the non-vitamin-K-antagonist oral anticoagulants (NOACs) which are increasingly used in atrial fibrillation (AF). In real life even patients with contraindications to vitamin K antagonists (VKAs) receive NOAC because NOAC are considered as "safer" than VKAs.
CASE DESCRIPTION: In a 61-years-old man with hypertension, heart failure and paroxysmal AF apixaban was started. Despite advices from his physicians, he continued alcohol abuse and suffered from recurrent falls. After 9 months he fell from a ladder and suffered from extensive subarachnoidal and intraparenchymal hemorrhages, subdural hematoma, brain edema with midline shift and a left-sided skull fracture. Because of the inability to reverse the anticoagulant therapy, no neurosurgical intervention was carried out and the patient died without regaining consciousness.
CONCLUSIONS: Patients with recurrent falls or chronic alcohol abuse should not be considered as candidates for NOACs. If anticoagulation is deemed necessary, VKA with its potential for prompt reversibility should be favored.
CASE DESCRIPTION: In a 61-years-old man with hypertension, heart failure and paroxysmal AF apixaban was started. Despite advices from his physicians, he continued alcohol abuse and suffered from recurrent falls. After 9 months he fell from a ladder and suffered from extensive subarachnoidal and intraparenchymal hemorrhages, subdural hematoma, brain edema with midline shift and a left-sided skull fracture. Because of the inability to reverse the anticoagulant therapy, no neurosurgical intervention was carried out and the patient died without regaining consciousness.
CONCLUSIONS: Patients with recurrent falls or chronic alcohol abuse should not be considered as candidates for NOACs. If anticoagulation is deemed necessary, VKA with its potential for prompt reversibility should be favored.