Mild traumatic brain injury presenting with delayed intracranial hemorrhage in warfarin therapy: a case report.
Identifieur interne : 001C46 ( Main/Exploration ); précédent : 001C45; suivant : 001C47Mild traumatic brain injury presenting with delayed intracranial hemorrhage in warfarin therapy: a case report.
Auteurs : Pearl Chung [Australie] ; Fary Khan [Australie]Source :
- Journal of medical case reports [ 1752-1947 ] ; 2015.
Descripteurs français
- KwdFr :
- Anticoagulants (effets indésirables), Facteurs temps (MeSH), Humains (MeSH), Hémorragies intracrâniennes (imagerie diagnostique), Hémorragies intracrâniennes (rééducation et réadaptation), Hémorragies intracrâniennes (étiologie), Lésions encéphaliques (complications), Mâle (MeSH), Sujet âgé (MeSH), Tomodensitométrie (MeSH), Warfarine (effets indésirables), Échelle de coma de Glasgow (MeSH).
- MESH :
- effets indésirables : Anticoagulants, Lésions encéphaliques, Warfarine.
- imagerie diagnostique : Hémorragies intracrâniennes.
- rééducation et réadaptation : Hémorragies intracrâniennes.
- étiologie : Hémorragies intracrâniennes.
- Facteurs temps, Humains, Mâle, Sujet âgé, Tomodensitométrie, Échelle de coma de Glasgow.
English descriptors
- KwdEn :
- Aged (MeSH), Anticoagulants (adverse effects), Brain Injuries (complications), Glasgow Coma Scale (MeSH), Humans (MeSH), Intracranial Hemorrhages (diagnostic imaging), Intracranial Hemorrhages (etiology), Intracranial Hemorrhages (rehabilitation), Male (MeSH), Time Factors (MeSH), Tomography, X-Ray Computed (MeSH), Warfarin (adverse effects).
- MESH :
- chemical , adverse effects : Anticoagulants, Warfarin.
- complications : Brain Injuries.
- diagnostic imaging : Intracranial Hemorrhages.
- etiology : Intracranial Hemorrhages.
- rehabilitation : Intracranial Hemorrhages.
- Aged, Glasgow Coma Scale, Humans, Male, Time Factors, Tomography, X-Ray Computed.
Abstract
INTRODUCTION
Current literature estimates the risk of delayed intracranial hemorrhage as between 0.6 and 6% after mild head injury for patients on warfarin. Due to resource allocation issues, the need to actually diagnose delayed intracranial haemorrhage has been questioned, especially if it does not require surgery. The purpose of our case report is to consider the functional implications during the six months following a mild traumatic brain injury complicated by delayed intracranial hemorrhage in a patient undergoing warfarin therapy. To the best of our knowledge, the rehabilitative and functional considerations of delayed intracranial haemorrhage in head injury have not been previously described in the literature.
CASE PRESENTATION
A previously independent 74-year-old Lebanese man living in Australia sustained mild traumatic brain injury following an unwitnessed fall from the height of two meters while on warfarin therapy, with an international normalized ratio of 4.2. He was found to have amnesia of the event and extensive facial bruising. His Glasgow Coma Scale score was 14 to 15 throughout observation. Following a non-diagnostic initial computerised tomography scan, a repeat scan at 24 hours from the injury identified large intracerebral, subdural and subarachnoid hemorrhages. A detailed examination demonstrated visuospatial and cognitive impairments. He required inpatient rehabilitation for three weeks, and outpatient rehabilitation for two months. By six months, he had returned to his pre-injury level of functioning, but was unable to resume driving.
CONCLUSIONS
We describe rehabilitation outcomes of delayed intracranial haemorrhage and mild traumatic brain injury, with diminishing disability over six months. In our case report, the complication of the delayed intracranial haemorrhage resulted in significant activity limitations and participation restrictions, which affected the clinical management, including the need for multidisciplinary rehabilitation. The risk of delayed intracranial haemorrhage in mild head injury remains a significant problem requiring further research.
DOI: 10.1186/s13256-015-0652-2
PubMed: 26282266
PubMed Central: PMC4539919
Affiliations:
Links toward previous steps (curation, corpus...)
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Glasgow</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>INTRODUCTION</b></p><p>Current literature estimates the risk of delayed intracranial hemorrhage as between 0.6 and 6% after mild head injury for patients on warfarin. Due to resource allocation issues, the need to actually diagnose delayed intracranial haemorrhage has been questioned, especially if it does not require surgery. The purpose of our case report is to consider the functional implications during the six months following a mild traumatic brain injury complicated by delayed intracranial hemorrhage in a patient undergoing warfarin therapy. To the best of our knowledge, the rehabilitative and functional considerations of delayed intracranial haemorrhage in head injury have not been previously described in the literature.</p></div><div type="abstract" xml:lang="en"><p><b>CASE PRESENTATION</b></p><p>A previously independent 74-year-old Lebanese man living in Australia sustained mild traumatic brain injury following an unwitnessed fall from the height of two meters while on warfarin therapy, with an international normalized ratio of 4.2. He was found to have amnesia of the event and extensive facial bruising. His Glasgow Coma Scale score was 14 to 15 throughout observation. Following a non-diagnostic initial computerised tomography scan, a repeat scan at 24 hours from the injury identified large intracerebral, subdural and subarachnoid hemorrhages. A detailed examination demonstrated visuospatial and cognitive impairments. He required inpatient rehabilitation for three weeks, and outpatient rehabilitation for two months. By six months, he had returned to his pre-injury level of functioning, but was unable to resume driving.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>We describe rehabilitation outcomes of delayed intracranial haemorrhage and mild traumatic brain injury, with diminishing disability over six months. In our case report, the complication of the delayed intracranial haemorrhage resulted in significant activity limitations and participation restrictions, which affected the clinical management, including the need for multidisciplinary rehabilitation. The risk of delayed intracranial haemorrhage in mild head injury remains a significant problem requiring further research.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26282266</PMID><DateCompleted><Year>2016</Year><Month>02</Month><Day>11</Day></DateCompleted><DateRevised><Year>2018</Year><Month>11</Month><Day>13</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1752-1947</ISSN><JournalIssue CitedMedium="Internet"><Volume>9</Volume><PubDate><Year>2015</Year><Month>Aug</Month><Day>18</Day></PubDate></JournalIssue><Title>Journal of medical case reports</Title><ISOAbbreviation>J Med Case Rep</ISOAbbreviation></Journal><ArticleTitle>Mild traumatic brain injury presenting with delayed intracranial hemorrhage in warfarin therapy: a case report.</ArticleTitle><Pagination><MedlinePgn>173</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s13256-015-0652-2</ELocationID><Abstract><AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">Current literature estimates the risk of delayed intracranial hemorrhage as between 0.6 and 6% after mild head injury for patients on warfarin. Due to resource allocation issues, the need to actually diagnose delayed intracranial haemorrhage has been questioned, especially if it does not require surgery. The purpose of our case report is to consider the functional implications during the six months following a mild traumatic brain injury complicated by delayed intracranial hemorrhage in a patient undergoing warfarin therapy. To the best of our knowledge, the rehabilitative and functional considerations of delayed intracranial haemorrhage in head injury have not been previously described in the literature.</AbstractText><AbstractText Label="CASE PRESENTATION" NlmCategory="METHODS">A previously independent 74-year-old Lebanese man living in Australia sustained mild traumatic brain injury following an unwitnessed fall from the height of two meters while on warfarin therapy, with an international normalized ratio of 4.2. He was found to have amnesia of the event and extensive facial bruising. His Glasgow Coma Scale score was 14 to 15 throughout observation. Following a non-diagnostic initial computerised tomography scan, a repeat scan at 24 hours from the injury identified large intracerebral, subdural and subarachnoid hemorrhages. A detailed examination demonstrated visuospatial and cognitive impairments. He required inpatient rehabilitation for three weeks, and outpatient rehabilitation for two months. By six months, he had returned to his pre-injury level of functioning, but was unable to resume driving.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">We describe rehabilitation outcomes of delayed intracranial haemorrhage and mild traumatic brain injury, with diminishing disability over six months. In our case report, the complication of the delayed intracranial haemorrhage resulted in significant activity limitations and participation restrictions, which affected the clinical management, including the need for multidisciplinary rehabilitation. The risk of delayed intracranial haemorrhage in mild head injury remains a significant problem requiring further research.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Chung</LastName><ForeName>Pearl</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>The University of Melbourne, Department of Rehabilitation Medicine, Royal Melbourne Hospital, 34-54 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia. pearl.chung@mh.org.au.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Khan</LastName><ForeName>Fary</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>The University of Melbourne, Department of Rehabilitation Medicine, Royal Melbourne Hospital, 34-54 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia. fary.khan@mh.org.au.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>08</Month><Day>18</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>J Med Case Rep</MedlineTA><NlmUniqueID>101293382</NlmUniqueID><ISSNLinking>1752-1947</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000925">Anticoagulants</NameOfSubstance></Chemical><Chemical><RegistryNumber>5Q7ZVV76EI</RegistryNumber><NameOfSubstance UI="D014859">Warfarin</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000925" MajorTopicYN="N">Anticoagulants</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001930" MajorTopicYN="N">Brain Injuries</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015600" MajorTopicYN="N">Glasgow Coma Scale</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020300" MajorTopicYN="N">Intracranial Hemorrhages</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000534" MajorTopicYN="Y">rehabilitation</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014057" MajorTopicYN="N">Tomography, X-Ray Computed</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014859" MajorTopicYN="N">Warfarin</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>02</Month><Day>10</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2015</Year><Month>07</Month><Day>13</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2015</Year><Month>8</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2015</Year><Month>8</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>2</Month><Day>13</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">26282266</ArticleId><ArticleId IdType="doi">10.1186/s13256-015-0652-2</ArticleId><ArticleId IdType="pii">10.1186/s13256-015-0652-2</ArticleId><ArticleId IdType="pmc">PMC4539919</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Neurosurgery. 2006 May;58(5):E851-6; 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