title: [Apixaban-Related Convexal Subarachnoid Hemorrhage:A Case Report].
abstract: The risk of anticoagulant-associated intracranial hemorrhage(ICH)is relatively low in patients treated with non-vitamin K antagonist oral anticoagulants(NOAC). The anticoagulant-associated ICH comprises mainly intraparenchimal hemorrhage. Subdural hematoma and subarachnoid hemorrhage(SAH)are rare complications after treatment with NOAC, trauma being the most common cause for these two types of ICH. We report a case of non-traumatic convexal SAH(cSAH)associated with Apixavan. A 68-year-old man with repeated history of cerebral embolism with cardiogenic cause presented with weakness of the lower limbs. Magnetic resonance imaging revealed infarctions, and treatment with apixaban(5 mg twice per day)was administered. Three days later, SAH in the right superior frontal sulcus was discovered incidentally on computed tomography(CT). NOAC-associated SAH is a rare manifestation. Cerebral amyloid angiopathy(CAA)is the most common cause of cSAH in the elderly, and cSAH is supposed to be a warning sign of cerebral hemorrhage in CAA. Patients with CAA started on NOAC require careful monitoring.
authors.affiliation: Department of Neurosurgery, Higashihiroshima Medical Center.
authors.forename: Kiyoharu
authors.initials: K
authors.lastname: Shimizu
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yuki
authors.forename: Takashi
authors.initials: T
authors.lastname: Sadatomo
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hara
authors.forename: Hideo
authors.initials: H
authors.lastname: Ohba
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kurisu
mesh_terms: D000368:Aged; D000792:Angiography; D065427:Factor Xa Inhibitors / Q000009:adverse effects*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D064847:Multimodal Imaging; D011720:Pyrazoles / Q000009:adverse effects*; D011728:Pyridones / Q000009:adverse effects*; D013345:Subarachnoid Hemorrhage / Q000139:chemically induced*; D014057:Tomography, X-Ray Computed
chemical_list: D065427:Factor Xa Inhibitors; D011720:Pyrazoles; D011728:Pyridones; C522181:apixaban