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A complicated case of anticoagulation

Rooshi Nathwani1

  • 1Department of General Medicine, Queen's Hospital Romford, Essex, UK. rooshi_n@hotmail.com

BMJ Case Reports
|January 12, 2013
PubMed

In this case of complex anticoagulation, a 60-year-old woman was treated with low-molecular-weight heparin for pulmonary embolism. As a result of anticoagulation, she then developed an acute subdural haemorrhage identified on CT brain scan requiring craniectomy. Subsequently, while continuing anticoagulation for treatment for pulmonary embolism, she additionally had a large intra-abdominal bleed within and around the psoas muscle identified on abdominal CT scan. Although the increased risk of bleeding is known with anticoagulation therapy, the case of both an intracerebral and intra-abdominal bleed is rare. However, the case does highlight how each individual has a unique physiological response to anticoagulation, in some cases more severe than others.

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