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Warfarine Kullanımına Bağlı Spontan Triseps Hematomu ve Radial Sinir Arazı

Year 2024, , 86 - 88, 04.07.2024
https://doi.org/10.38175/phnx.1465400

Abstract

Antikoagülan olarak warfarin kullanan hastalarda kas içi kanamalar ve hematomlar antikoagülasyonun bir komplikasyonu olarak karşımıza çıkmaktadır. Hematomlar travmaya bağlı olabileceği gibi spontan da gelişebilir. Hematomların direk basısı nedeniyle veya sinir çevresine olan kanamalara bağlı olarak nöropatiler nadiren karşımıza çıkabilmektedir. Kapak hastalığı nedeniyle warfarin kullanan hastada spontan triseps kası içerisinde hematom ve buna bağlı gelişen radial sinir arazı gelişen olgumuzu sunmayı amaçladık. Protrombin kompleks ektresi ve K vitamini sonrası hemotom boşaltılmış ve takibinde hastanın sinir kusuru düzelmiştir. Hematomun erken boşaltılması yüz güldürücü sonuçlar açısından önemli olabilir.

References

  • Yaycioğlu S, Ak H. Concomitant ulnar and median nerve entrapment due to spontaneous hematomas at humerus mid-shaft under warfarin treatment: Case report. Journal of Neurological Sciences (Turkish). 2010;27:239-243.
  • Wiedermann CJ, Stockner I. Warfarin-induced bleeding complications clinical presentation and therapeutic options. Thromb Res. 2008;122 Suppl 2:S13-8.
  • K Reddy VP, Rangasami R, Vignesh G. Sciatic Nerve Hematoma-Case Report. Neurol India. 2021;69:1043-1044.
  • Apostolopoulos A, Kosmas L, Angelis S, Balfousias T, Filippou D. Femoral Nerve Palsy Secondary to Iliopsoas Spontaneous Haematoma in a Patient Under Warfarin Treatment. Cureus. 2020;12:e7610.
  • Dagar S, Emektar E, Uzunosmanoglu H, Cevik Y. Assessment of factors affecting mortality in geriatric patients with warfarin overdose. Turk J Emerg Med. 2020;20:180-185.
  • Takahashi K, Nihei T, Aoki Y, Nakagawa M, Konno N, Munakata A, Okawara K, Kashimura H. Spontaneous rectus sheath hematoma associated with warfarin administration: a case report. J Rural Med. 2019;14:245-248.
  • King RB, Bechtold DL. Warfarin-induced iliopsoas hemorrhage with subsequent femoral nerve palsy. Ann Emerg Med. 1985;14:362-4.
  • Elesber AA, Kent PD, Jennings CA. Compressive neuropathy of the brachial plexus and long thoracic nerve: a rare complication of heparin anticoagulation. Chest. 2001;120:309-11.
  • Parmer SS, Carpenter JP, Fairman RM, Velazquez OC, Mitchell ME. Femoral neuropathy following retroperitoneal hemorrhage: case series and review of the literature. Ann Vasc Surg. 2006;20:536-40.

Spontaneous Triceps Hematoma and Radial Nerve Impairment due to Warfarin Use

Year 2024, , 86 - 88, 04.07.2024
https://doi.org/10.38175/phnx.1465400

Abstract

Intramuscular hemorrhages and hematomas are a complication of anticoagulation in patients using warfarin as an anticoagulant. Hematomas may be due to trauma or may develop spontaneously. Neuropathies due to direct compression of hematomas or hemorrhage around the nerve may rarely occur. We aimed to present a case of spontaneous hematoma in the triceps muscle and associated radial nerve deficit in a patient taking warfarin for valvular disease. The hematoma was evacuated after prothrombin complex concentrate and vitamin K. The patient’s nerve deficit improved in the follow-up. Early evacuation of the haematoma may be important for favorable outcomes.

Ethical Statement

The patient informed consent form was obtained

Supporting Institution

There is no financial support of any person or institution in this research

References

  • Yaycioğlu S, Ak H. Concomitant ulnar and median nerve entrapment due to spontaneous hematomas at humerus mid-shaft under warfarin treatment: Case report. Journal of Neurological Sciences (Turkish). 2010;27:239-243.
  • Wiedermann CJ, Stockner I. Warfarin-induced bleeding complications clinical presentation and therapeutic options. Thromb Res. 2008;122 Suppl 2:S13-8.
  • K Reddy VP, Rangasami R, Vignesh G. Sciatic Nerve Hematoma-Case Report. Neurol India. 2021;69:1043-1044.
  • Apostolopoulos A, Kosmas L, Angelis S, Balfousias T, Filippou D. Femoral Nerve Palsy Secondary to Iliopsoas Spontaneous Haematoma in a Patient Under Warfarin Treatment. Cureus. 2020;12:e7610.
  • Dagar S, Emektar E, Uzunosmanoglu H, Cevik Y. Assessment of factors affecting mortality in geriatric patients with warfarin overdose. Turk J Emerg Med. 2020;20:180-185.
  • Takahashi K, Nihei T, Aoki Y, Nakagawa M, Konno N, Munakata A, Okawara K, Kashimura H. Spontaneous rectus sheath hematoma associated with warfarin administration: a case report. J Rural Med. 2019;14:245-248.
  • King RB, Bechtold DL. Warfarin-induced iliopsoas hemorrhage with subsequent femoral nerve palsy. Ann Emerg Med. 1985;14:362-4.
  • Elesber AA, Kent PD, Jennings CA. Compressive neuropathy of the brachial plexus and long thoracic nerve: a rare complication of heparin anticoagulation. Chest. 2001;120:309-11.
  • Parmer SS, Carpenter JP, Fairman RM, Velazquez OC, Mitchell ME. Femoral neuropathy following retroperitoneal hemorrhage: case series and review of the literature. Ann Vasc Surg. 2006;20:536-40.
There are 9 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section Case Reports
Authors

Zeynep Saral Öztürk 0000-0002-5126-4589

Emine Emektar 0000-0002-6056-4401

Yunsur Çevik 0000-0003-1325-0909

Early Pub Date July 4, 2024
Publication Date July 4, 2024
Submission Date April 6, 2024
Acceptance Date July 1, 2024
Published in Issue Year 2024

Cite

Vancouver Saral Öztürk Z, Emektar E, Çevik Y. Spontaneous Triceps Hematoma and Radial Nerve Impairment due to Warfarin Use. Phnx Med J. 2024;6(2):86-8.

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