Perioperative management of acute ischemic stroke: a case report.
Interrupting anticoagulation in patients at high risk for thromboembolism, even for critically important surgery, may lead to devastating outcomes. The patient described developed "Locked-in Syndrome" from basilar arterial thrombosis within 24 hours of withholding anticoagulation for urgent airway surgery. Emergency thrombolysis partially restored arterial flow, with recovery of some function. The dangers of hemorrhage during surgery must be balanced against the potentially devastating consequences of withholding anticoagulation in patients at high risk for thrombosis.
Phon
Hla
H
Department of Anesthesiology, Drexel University College of Medicine, Philadelphia, PA 19102-1192, USA.
Jaffe
Jeremy
J
Horrow
Jay
J
D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects; D001488:Basilar Artery; D002545:Brain Ischemia / Q000209:etiology*; D006801:Humans; D008297:Male; D011782:Quadriplegia / Q000209:etiology*; D020521:Stroke / Q000628:therapy*; D013927:Thrombosis / Q000139:chemically induced* / Q000150:complications
D000925:Anticoagulants