KITAGAWA KAZUO    Department   Other, Other    Position
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
Authorship	Last author
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