[Factor Xa Inhibitor for the Treatment of Cerebral Venous Thrombosis with Intracerebral Hemorrhage during Anticoagulation Therapy:A Case Report].

A 46-year-old man presented with headache, right hemiparesis, and motor aphasia. A diagnosis of cerebral venous thrombosis with subarachnoid hemorrhage was made. We started intravenous administration of unfractionated heparin. After 6 days in hospital, the right hemiparesis and motor aphasia worsened, and brain computed tomographic(CT)images demonstrated intracerebral hemorrhage in the left parietal lobe. Therefore, we switched treatment from heparin to apixaban. His condition improved and a brain magnetic resonance(MR)venogram after 7 days in hospital showed recanalization of the cerebral veins. He was discharged with no apparent neurological defects 33 days after onset and his modified Rankin Scale score was 1. In cases of progressive cerebral venous thrombosis with intracerebral hemorrhage, during anticoagulation, it is necessary to achieve recanalization of the occluded cerebral vein rapidly without spreading the intracerebral hemorrhage. Factor Xa inhibitors, especially apixaban, may be another option for treating cerebral venous thrombosis with intracerebral hemorrhage.