Bleeding of a familial cerebral cavernous malformation after prophylactic anticoagulation therapy. Case report.
The risk of hemorrhage in cavernous malformations (CMs) depends on lesion, host, and environmental factors. Anticoagulation therapy is a well-known risk factor for intracerebral bleeding, but the occurrence of hemorrhages in patients with CMs has not been reported. Low molecular weight heparin therapy is generally considered to be safe, although significant hemorrhagic complications have recently been reported. The authors report a case of intralesional bleeding in a CM after prophylactic anticoagulation therapy was administered in a patient with the familial form of the disease. The leaky endothelial structure of CMs may constitute an unexpected target of the vascular effects of heparin.
Pozzati
Eugenio
E
Department of Neurosurgery, Bellaria Hospital, Bologna, Italy. Eugenio.Pozzati@ausl.bo.it
Zucchelli
Mino
M
Marliani
Anna Federica
AF
Riccioli
Luca Albini
LA
D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects; D001932:Brain Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D002540:Cerebral Cortex / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000139:chemically induced* / Q000503:physiopathology; D002550:Cerebral Veins / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D020786:Hemangioma, Cavernous, Central Nervous System / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects*; D006801:Humans; D007044:Hysterectomy; D000075927:KRIT1 Protein; D007889:Leiomyoma / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008869:Microtubule-Associated Proteins / Q000235:genetics; D009154:Mutation / Q000235:genetics; D011182:Postoperative Care; D011518:Proto-Oncogene Proteins / Q000235:genetics; D012307:Risk Factors; D013927:Thrombosis / Q000188:drug therapy / Q000517:prevention & control
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D000075927:KRIT1 Protein; C107928:KRIT1 protein, human; D008869:Microtubule-Associated Proteins; D011518:Proto-Oncogene Proteins