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抗凝治疗在脑海绵状血管畸形二级预防中的应用:一例报告

Use of Anticoagulation for Secondary Stroke Prevention in Cerebral Cavernous Malformations: A Case Report.

作者信息

Blackbourn Lisle W, Kim Melissa, Comardelle Nicholas J, Reddy Deepak

机构信息

Neurology, University of Illinois College of Medicine Peoria, Peoria, USA.

Neurology, OSF Illinois Neurological Institute, Peoria, USA.

出版信息

Cureus. 2025 Feb 12;17(2):e78913. doi: 10.7759/cureus.78913. eCollection 2025 Feb.

Abstract

The use of anticoagulation for secondary stroke prevention in patients with cerebral cavernous malformations remains a complex and challenging clinical scenario due to fear of hemorrhagic complications. Independent bleeding risks to take into account include patient age, infratentorial location, cerebral cavernous malformation size, and the association with a developmental venous anomaly. Multidisciplinary consultation involving input from neurology, neurosurgery, cardiology, and radiology is also often crucial to optimize patient outcomes in this setting. Here, we present a case of a 58-year-old woman with known cerebral cavernous malformations presenting with a posterior cerebral artery ischemic stroke secondary to atrial fibrillation to discuss the safety of anticoagulation for secondary stroke prevention in such cases.

摘要

由于担心出血并发症,在患有脑海绵状血管畸形的患者中使用抗凝药物进行二级卒中预防仍然是一个复杂且具有挑战性的临床情况。需要考虑的独立出血风险包括患者年龄、幕下位置、脑海绵状血管畸形大小以及与发育性静脉异常的关联。在这种情况下,由神经科、神经外科、心脏病科和放射科共同参与的多学科会诊对于优化患者预后也往往至关重要。在此,我们报告一例58岁已知患有脑海绵状血管畸形的女性患者,其因心房颤动继发大脑后动脉缺血性卒中,以讨论在此类病例中使用抗凝药物进行二级卒中预防的安全性。

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