Cerebellar hemorrhage provoked by combined use of nattokinase and aspirin in a patient with cerebral microbleeds.
Nattokinase is used as a health-promoting medicine for preventing thrombosis due to its fibrinolytic activity. Cerebral microbleed is remnant of blood extravasations from the damaged vessels related to cerebral microangiopathies. We report a patient, having used aspirin for secondary stroke prevention, who had an acute cerebellar hemorrhage after taking nattokinase 400 mg daily for 7 consecutive days. In addition to the hemorrhagic lesion, multiple microbleeds were demonstrated on brain MR images. We suggest that nattokinase may increase risk of intracerebral hemorrhage in patients who have bleeding-prone cerebral microangiopathy and are receiving other antithrombotic agent at the same time.
Chang
Yung-Yee
YY
Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Liu
Jia-Shou
JS
Lai
Shung-Lon
SL
Wu
Hsiu-Shan
HS
Lan
Min-Yu
MY
D001241:Aspirin / Q000009:adverse effects*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects*; D041743:Herb-Drug Interactions; D006801:Humans; D020300:Intracranial Hemorrhages / Q000139:chemically induced* / Q000000981:diagnostic imaging; D002546:Ischemic Attack, Transient / Q000517:prevention & control; D008875:Middle Aged; D010936:Plant Extracts / Q000009:adverse effects; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D012651:Self Medication / Q000009:adverse effects*; D020521:Stroke / Q000150:complications; D013381:Subtilisins / Q000009:adverse effects*; D013927:Thrombosis / Q000517:prevention & control; D014057:Tomography, X-Ray Computed
D005343:Fibrinolytic Agents; D010936:Plant Extracts; D010975:Platelet Aggregation Inhibitors; D013381:Subtilisins; C053771:nattokinase; D001241:Aspirin