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Superficial siderosis and anticoagulation therapy: different presentations, different outcomes
Rui Duarte Barreto1, Luís Ruano, Vítor Tedim Cruz
1Department of Neurology, Entre Douro e Vouga Hospital Center, Rua Dr. Cândido de Pinho, Santa Maria da Feira, 4520-211 Aveiro, Portugal.
Case Reports in Neurological Medicine
|October 24, 2012
Summary
Superficial siderosis, a neurodegenerative disorder, may be linked to oral anticoagulants. Discontinuing anticoagulation in one patient with superficial siderosis led to significant motor and cognitive recovery, suggesting a modifiable factor.
Area of Science:
- Neurology
- Neurodegenerative Disorders
- Iron Metabolism
Background:
- Superficial siderosis is a neurodegenerative condition characterized by iron deposition on the central nervous system surfaces.
- Chronic subarachnoid hemorrhage is the primary cause, with a potential link to oral anticoagulant therapy that requires further investigation.
Purpose of the Study:
- To investigate the role of oral anticoagulants in superficial siderosis.
- To explore the potential for managing superficial siderosis by modifying anticoagulant therapy.
Main Methods:
- Case study of two women on long-term oral anticoagulation presenting with symptoms suggestive of superficial siderosis.
- Magnetic resonance imaging (MRI) used to identify characteristic hypointensities.
- Clinical assessment of patient outcomes following discontinuation or continuation of anticoagulation.
Main Results:
- Both patients exhibited MRI findings consistent with superficial siderosis.
- One patient, whose anticoagulation was discontinued, showed marked motor and cognitive improvement.
- The patient who continued anticoagulation experienced slow, progressive worsening of symptoms.
Conclusions:
- Oral anticoagulation may be a contributing or exacerbating factor in superficial siderosis, particularly when no other bleeding source is identified.
- Discontinuation of anticoagulation can lead to significant clinical improvement in some patients with superficial siderosis.
- Considering anticoagulation status as a modifiable factor is crucial for managing superficial siderosis.
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