Iijima Mutsumi
Department School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine Position Professor |
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Article types | Case report |
Language | Japanese |
Peer review | Peer reviewed |
Title | A case of the atherothrombotic cerebral infarction showed progressing stroke after discontinuation of the direct thrombin inhibitor |
Journal | Formal name:Japanese Journal of Stroke Abbreviation:Jpn J Stroke ISSN code:09120726 |
Domestic / Foregin | Domestic |
Volume, Issue, Page | pp.446-451 |
Author and coauthor | Eiko Higuchi†, Yumiko Uchiyama*, Mutsumi Iizima,and Kazuo Kitagawa |
Publication date | 2015/11 |
Summary | We report the case of an 81-year-old man with a progressive atherothrombotic cerebral infarction at posterior circulation.
He suddenly complained of nausea, vertigo, and vomiting. His neurological findings showed dysarthria, nystagmus to left side, and limb ataxia of the right arm. Brain MRI and MRA showed cerebral infarctions on the right hemisphere of the cerebellum and the left occipital lobe with severe stenosis in the vertebral and basilar arteries. He was treated with argatroban by dual antiplatelet therapy. After argatroban was discontinued at day 5, clinical symptoms became worse and new infarctions appeared in the brainstem and at the left side of cerebellar hemisphere. Therefore, heparinization was started and the clinical symptoms became stable. Based on the sudden neurological worsening after discontinuation of argatroban, we speculate that anticoagulation would be necessary to prevent worsening and recurrence in the acute stage of atherothromobotic brain infarction. |
DOI | 2016086229 |