Upper extremity deep vein thrombosis in a patient with hemorrhagic stroke--a case report/Hemorajik inmeli bir hastada ust ekstremite derin ven trombozu: olgu sunumu

In this article, we present a 55-year-old woman with hemorrhagic stroke who had upper extremity deep venous thrombosis (DVT) at the hemiplegic side and a review of the literature concerning the DVT treatment after hemorrhagic stroke. Her right upper extremity was flaccid. The passive movements of th...

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Bibliographic Details
Published in:Türkiye fiziksel tip ve rehabilitasyon dergisi 2009-12, p.173
Main Authors: Yasar, Evren, Alaca, Ridvan, Safaz, Ismail, Goktepe, Salim
Format: Article
Language:Turkish
Subjects:
Case studies
Complications and side effects
Pulmonary embolism
Risk factors
Stroke (Disease)
Venous thrombosis
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Summary:In this article, we present a 55-year-old woman with hemorrhagic stroke who had upper extremity deep venous thrombosis (DVT) at the hemiplegic side and a review of the literature concerning the DVT treatment after hemorrhagic stroke. Her right upper extremity was flaccid. The passive movements of the right shoulder were painful and there was mild edema localized in her right hand. Duplex ultrasound scanning was performed to investigate any thrombosis causing edema in the right upper extremity and a thrombus in right vena basilica was determined. We administered nadroparine calcium 19,000 IUAxa daily for 10 days subcutaneously and observed that deep venous system of right upper extremity was cleared after two weeks. The use of anticoagulants in the prevention or treatment of DVT in patients with hemorrhagic stroke is potentially hazardous and there is lack of information about this issue in the literature. In our opinion, low-molecular-weight heparins may be a relatively good choice to treat upper extremity DVT and to prevent highly fatal pulmonary embolism in patients with hemorrhagic stroke. Turk J Phys Med Rehab 2009;55:173-5. Key Words: Hemorrhagic stroke, upper extremity edema, deep venous thrombosis Bu makalede, hemiplejik tarafinda ust ekstremite derin ven trombozu (DVT) olan hemorajik inmeli, 55 yasinda bir kadin hasta ile hemorajik inmede DVT tedavisi hakkindaki literaturlerin bir derlemesini sunuyoruz. Sag ust ekstremitesi flaskti. Pasif sag omuz hareketleri agrili idi ve sag elinde lokalize hafif odem mevcuttu. Duplex ultrasonografik tarama yapilarak sag ust ekstremitesinde odeme yol acan herhangi tromboz varligi arastirildi ve sag vena basilikada bir trombus saptandi. Subkutan olarak 10 gun sureyle, gunluk 19.000 IUAxa "nadroparin kalsiyum" uygulandi ve 2 hasta sonra sag ust ekstremite derin venoz sisteminin temizlendigi goruldu. Hemorajik inmeli hastalarda DVT'nin onlenmesi veya tedavisinde antikoagulanlarin kullanimi potansiyel olarak risklidir ve mevcut literaturde bu konuda bilgi eksikligi vardir. Bizim gorusumuze gore, hemorajik inmeli hastalarda dusuk molekul agirlikli heparinler ust ekstremite DVT'sinin tedavisinde ve oldukca olumcul olan pulmoner embolinin onlenmesinde goreceli olarak iyi bir secenek olabilir. Turk Fiz Tip Rehab Derq 2009;55:173-5. Anahtar Kelimeler: Hemorajik inme, ust ekstremite odemi, derin ven trombozu
ISSN:1302-0234