title: [Cerebral infarct in chronic acetylsalicylic acid poisoning].
abstract: Salicylates increase the risk of hemorrhage. An ischemic brain infarct has not previously been described following intoxication with salicylates. Case report. A 58-year-old comatose patient was admitted with symptoms of a basilar artery thrombosis. A diagnostic angiography was impossible because laboratory results showed a prothrombin time (Quick) of 9% and a toxic salicylate level of 528 mg/l. During the next few days CCT and MRI scans revealed ischemic infarctions within the brain stem. Discussion. Salicylates can induce hemorrhage both by inhibiting platelet aggregation and - especially in higher doses - by vitamin K antagonism, leading to severe coagulopathy. The occurrence of an ischemic infarction, as presented in this case report, can be explained by a reduction of the vitamin K-dependent protein C level.
authors.affiliation: Neurologische Klinik, Universitätskliniken des Saarlandes, Homburg.
authors.forename: J
authors.initials: J
authors.lastname: Treib
authors.forename: F
authors.initials: F
authors.lastname: Blaes
authors.forename: A
authors.initials: A
authors.lastname: Haass
authors.forename: D
authors.initials: D
authors.lastname: Ohlmann
authors.forename: G
authors.initials: G
authors.lastname: Pindur
authors.forename: G F
authors.initials: GF
authors.lastname: Hamann
mesh_terms: D001241:Aspirin / Q000506:poisoning*; D001488:Basilar Artery / Q000000981:diagnostic imaging; D001780:Blood Coagulation Tests; D001933:Brain Stem / Q000098:blood supply*; D002533:Cerebral Angiography / Q000187:drug effects; D002544:Cerebral Infarction / Q000139:chemically induced* / Q000000981:diagnostic imaging; D004305:Dose-Response Relationship, Drug; D062787:Drug Overdose / Q000150:complications*; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000139:chemically induced / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000187:drug effects
chemical_list: D001241:Aspirin
vernacular_title: Hirninfarkt unter chronischer Acetylsalicylsäurevergiftung.