title: Cerebellar hemorrhage provoked by combined use of nattokinase and aspirin in a patient with cerebral microbleeds.
abstract: 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.
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Yung-Yee
authors.initials: YY
authors.lastname: Chang
authors.forename: Jia-Shou
authors.initials: JS
authors.lastname: Liu
authors.forename: Shung-Lon
authors.initials: SL
authors.lastname: Lai
authors.forename: Hsiu-Shan
authors.initials: HS
authors.lastname: Wu
authors.forename: Min-Yu
authors.initials: MY
authors.lastname: Lan
mesh_terms: 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
chemical_list: D005343:Fibrinolytic Agents; D010936:Plant Extracts; D010975:Platelet Aggregation Inhibitors; D013381:Subtilisins; C053771:nattokinase; D001241:Aspirin