Kerr Neal, Kerr Jasmin, Faed James M, Krysa Jo
Neurosurgery, Dunedin Hospital, Dunedin, New Zealand.
Internal Medicine, Dunedin Hospital, Dunedin, New Zealand.
BMJ Case Rep. 2018 Jun 23;2018:bcr-2018-225249. doi: 10.1136/bcr-2018-225249.
We present a rare case of intracerebral haemorrhage secondary to consumptive coagulopathy in relation to ongoing endoleak after thoracic endovascular aneurysm repair (TEVAR). A 68-year-old man underwent elective TEVAR for an 18 cm diameter Crawford type II thoracoabdominal aneurysm. He was subsequently shown to have a type 1b endoleak and a short episode of disseminated intravascularcoagulation (DIC) perioperatively. Two months after the procedure, he experienced a consumptive coagulopathy leading to intracerebral haemorrhage and ultimately his death. Endoleak-related DIC is an underappreciated phenomenon within the medical literature. Currently, management is reliant on general DIC principles and anecdotal experiences of others within the case report literature.
我们报告了一例罕见的脑内出血病例,其继发于与胸主动脉腔内修复术(TEVAR)后持续存在的内漏相关的消耗性凝血病。一名68岁男性因直径18厘米的Crawford II型胸腹主动脉瘤接受了择期TEVAR手术。随后发现他在围手术期有1b型内漏和短暂的弥散性血管内凝血(DIC)发作。术后两个月,他出现消耗性凝血病,导致脑内出血,最终死亡。内漏相关的DIC是医学文献中一个未得到充分认识的现象。目前,治疗依赖于一般的DIC原则以及病例报告文献中其他人的经验。