Nathwani Rooshi
Department of General Medicine, Queen's Hospital Romford, Essex, UK.
BMJ Case Rep. 2013 Jan 9;2013:bcr2012007672. doi: 10.1136/bcr-2012-007672.
In this case of complex anticoagulation, a 60-year-old woman was treated with low-molecular-weight heparin for pulmonary embolism. As a result of anticoagulation, she then developed an acute subdural haemorrhage identified on CT brain scan requiring craniectomy. Subsequently, while continuing anticoagulation for treatment for pulmonary embolism, she additionally had a large intra-abdominal bleed within and around the psoas muscle identified on abdominal CT scan. Although the increased risk of bleeding is known with anticoagulation therapy, the case of both an intracerebral and intra-abdominal bleed is rare. However, the case does highlight how each individual has a unique physiological response to anticoagulation, in some cases more severe than others.
在这个复杂抗凝治疗的病例中，一名60岁女性因肺栓塞接受了低分子量肝素治疗。抗凝治疗后，她在脑部CT扫描中被发现发生急性硬膜下出血，需要进行开颅手术。随后，在继续进行肺栓塞抗凝治疗期间，她在腹部CT扫描中又被发现腰大肌内及周围有大量腹腔内出血。尽管抗凝治疗会增加出血风险是已知的，但同时发生脑内和腹腔内出血的情况却很罕见。然而，这个病例确实凸显了每个人对抗凝治疗都有独特的生理反应，在某些情况下比其他情况更严重。
