title: Muscle haematoma due to antithrombotic treatment for ischaemic stroke.
abstract: The purpose of this study was to evaluate the incidence and clinical features of muscle haematoma in ischaemic stroke patients. Muscle haematomas are rare complications that occur during antithrombotic treatment for acute ischaemic stroke. Clinical and laboratory records of ischaemic stroke patients with muscle haematomas in the last 3.5 years were retrospectively reviewed. Muscular haematoma developed in three of 694 (0.4%) consecutive patients with acute ischaemic stroke who were admitted to our institution. In addition, one outpatient presenting with muscle haematoma was found during the same period. The types of haematomas were rectus sheath haematoma in two patients and iliopsoas haematoma in the remaining two. All three acute patients received both antiplatelet and anticoagulant therapies. The outpatient was treated with warfarin. Initial symptoms of haematoma included pain (n = 3) and syncope (n = 1). No patient was correctly diagnosed at the onset of muscle haematoma. At initial examination of muscle haematoma, no patients showed skin lesions. An ecchymosis developed in the abdominal area at an average of 3 days after the initial symptoms. Mean decrease in haemoglobin was 6.8 g/dL from baseline. None required surgery whereas two patients required blood transfusion. Muscle haematomas in stroke patients receiving antithrombotic therapy are rare complications that are difficult to diagnose at onset. The possibility of muscle haematoma should be considered in patients with ischaemic stroke undergoing antithrombotic therapy and presenting with acute pain and syncope, even if skin manifestations or a palpable mass are lacking.
authors.affiliation: Department of Neurology, Chiba Rosai Hospital, 2-16 Tatsumidai-Higashi, Ichihara-shi, Chiba 290-0003, Japan. Electronic address: hiragaa@yahoo.co.jp.
authors.forename: Akiyuki
authors.initials: A
authors.lastname: Hiraga
authors.affiliation: Department of Neurology, Chiba Rosai Hospital, 2-16 Tatsumidai-Higashi, Ichihara-shi, Chiba 290-0003, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Nakagawa
authors.affiliation: Department of Neurology, Chiba Rosai Hospital, 2-16 Tatsumidai-Higashi, Ichihara-shi, Chiba 290-0003, Japan.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Kamitsukasa
authors.affiliation: Department of Surgery, Chiba Rosai Hospital, Chiba, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuwabara
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D002545:Brain Ischemia / Q000150:complications* / Q000188:drug therapy*; D004438:Ecchymosis / Q000209:etiology; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006406:Hematoma / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D009135:Muscular Diseases / Q000209:etiology* / Q000628:therapy; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications* / Q000188:drug therapy*; D013575:Syncope / Q000150:complications
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors
keywords: Cerebrovascular disorders; Ischaemic stroke; Muscular haematoma