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Related Experiment Videos

Acute subdural haematomas and enoxaparin.

S Olson1, R Rossato, E Guazzo

  • 1Townsville General Hospital, Eyre Street, North Ward, Townsville, Queensland, 4810, Australia. sarahl_olson@hotmail.com

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|July 3, 2002
PubMed
Summary

Therapeutic enoxaparin doses were linked to severe brain bleeds in North Queensland. Unfractionated heparin did not show similar risks, suggesting caution with enoxaparin for central nervous system bleeding complications.

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Area of Science:

  • Neurology
  • Pharmacology
  • Hematology

Background:

  • Low molecular weight heparins (LMWH) like enoxaparin are established treatments for deep vein thrombosis (DVT) and ischemic heart disease (IHD).
  • Townsville General Hospital (TGH) serves a large population in North Queensland, utilizing anticoagulants for patient care.

Observation:

  • A review of cases at TGH between November 1998 and December 1999 identified three instances of acute subdural hematomas (ASDH).
  • These severe intracranial hemorrhages were associated with patients receiving therapeutic doses of enoxaparin.
  • In contrast, unfractionated heparin (UFH), used during the same period, was not associated with any intracranial hemorrhages.

Findings:

  • Therapeutic enoxaparin administration was linked to fatal or severely disabling acute subdural hematomas (ASDH) in a hospital setting.

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  • The incidence of intracranial hemorrhage with enoxaparin contrasted with the absence of such events with unfractionated heparin (UFH) during the same period.

    • Implications:

    • The findings raise concerns about the potential hemorrhagic complications of therapeutic enoxaparin, particularly within the central nervous system.
    • Clinical practice may need to re-evaluate the risk-benefit profile of enoxaparin in specific patient populations or contexts, especially concerning CNS bleeding risks.