Treatment of a patient diagnosed with cerebral hemorrhage complicated by atypical pulmonary embolism in the rehabilitation department: Case report and anatomical factors analysis.

OBJECTIVE

This report documents the occurrence, clinical management, and outcome of a patient diagnosed with an atypical pulmonary embolism (PE) complicating subacute cerebral hemorrhage in a rehabilitation setting. By integrating the relevant literature, this study aimed to provide a clinical reference for the diagnosis and treatment of atypical PE in patients undergoing post-hemorrhagic rehabilitation.

CASE: The medical history and imaging data from a patient diagnosed with atypical PE during the subacute phase after intracerebral hemorrhage in a rehabilitation setting were analyzed. After diagnostic confirmation, anticoagulation and symptomatic therapies were initiated. A literature review exploring anatomical factors underlying PE in this clinical context was performed. After multidisciplinary treatment, the patient's PE lesions disappeared and indicators, such as blood pressure and heart rate, returned to normal.

CONCLUSION

Intracerebral hemorrhage complicated by atypical PE is a relatively uncommon occurrence in the rehabilitation ward. In this case, conservative low-dose nadroparin calcium anticoagulation was associated with marked biochemical improvement and complete bilateral pulmonary artery clearance on follow-up CTA, without recurrent intracranial hemorrhage. Although no domestic or international guidelines currently address intracerebral hemorrhage complicated by atypical PE, our experience suggests that early prevention, timely diagnosis, individualized anticoagulation, and multidisciplinary collaboration can enable safe and effective management in carefully selected patients.