J Korean Neurosurg Soc.  1996 Jan;25(1):184-187.

Acute Subdural Hematoma Developed During Anticoagulant or Thrombolytic Therapy in Patients with Cerebral Infarction

• Kim GC
• Lim YJ
• Kim HD
• Kim TS
• Kim GK
• Rhee BA
• Leem W

Abstract

Patients with cardiogenic embolic stroke may experience an early, recurrent cerebral embolism. Fortunately, limited evidence suggests that anticoagulatory agents or thrombolytic agents may prevent recurrent cardiogenic emboli and halt progression of so-called "progressing stroke" However, because of the possibility of the intracerebral hemorrhage, use of such agents has generally been considered cautiously with timing, dosage and patient selection. Serious complications of anticoagulation for presumed embolic stroke are hemorrhage in the area of infarction. We experienced two patients with nonseptic cerebral embolism of cardiac origin. They were managed with anticoagulant or thrombolytic therapy, but resulted in clinical deterioration or death from spontaneous subdural hemorrhage. In each patient, an initial CT scan excluded the presence of hemorrhage but a second CT scan after clinical deterioration, documented subdural hemorrhage.

Keyword

Cerebral infarction; Thrombolytic therapy; Anticoagulant therapy; Acute subdural hemorrhage

MeSH Terms

Cerebral Hemorrhage
Cerebral Infarction*
Fibrinolytic Agents
Hematoma, Subdural
Hematoma, Subdural, Acute*
Hemorrhage
Humans
Infarction
Intracranial Embolism
Patient Selection
Stroke
Thrombolytic Therapy*
Tomography, X-Ray Computed
Fibrinolytic Agents