Acute subdural haematomas and enoxaparin.
Townsville General Hospital (TGH) has 285 beds and serves a population of approximately 500,0000 in North Queensland. In the period November 1998 until December 1999 there were three acute subdural haematomas (ASDH) related to therapeutic doses of enoxaparin. These culminated in death or severe neurological disability. Unfractionated heparin (UFH) is probably used equivalently in TGH. There were no intracranial haemorrhages in this period with UFH. It is well known low molecular weight heparins (LMWH) have a proven place in the management of deep vein thrombosis (DVT) and ischaemic heart disease (IHD). There may however be some concerns regarding the haemorrhagic complications of therapeutic doses of enoxaparin in the central nervous system.
Olson
S
S
Townsville General Hospital, Eyre Street, North Ward, Townsville, Queensland, 4810, Australia. sarahl_olson@hotmail.com
Rossato
R
R
Guazzo
E
E
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D017984:Enoxaparin / Q000009:adverse effects*; D017809:Fatal Outcome; D015600:Glasgow Coma Scale; D006408:Hematoma, Subdural / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
D000925:Anticoagulants; D017984:Enoxaparin