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Abstract
RÉSUMÉ
La survenue d’une embolie pulmonaire après une hémorragie spontanée intracérébrale constitue un défi pour le clinicien dans les milieux à ressources faibles et intermédiaires. Cet état étant généralement associé à une hypertension artérielle. En effet, l’anticoagulation expose à un risque de récidive hémorragique potentiellement délétère et difficile en prendre en charge dans ce contexte. Ce cas clinique illustre la complexité de la prise en charge de ces patients et met en exergue l’intérêt de l’utilisation des nouveaux anticoagulants oraux dans cette situation.
ABSTRACT
The occurrence of pulmonary embolism after spontaneous intracerebral hemorrhage is a challenge for the clinician in low- and intermediate-resource settings. This condition is generally associated with arterial hypertension. Indeed, anticoagulation exposes the patient to a potentially deleterious risk of hemorrhagic recurrence, which is difficult to manage in this context. This case study illustrates the complexity of managing these patients, and highlights the value of using the new oral anticoagulants in this situation.
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References
- Becattini C, Cimini LA, Carrier M. Challenging anticoagulation cases: A case of pulmonary embolism shortly after spontaneous brain bleeding. Thromb Res. avr 2021;200:41-7.
- Cai Q, Zhang X, Chen H. Patients with venous thromboembolism after spontaneous intracerebral hemorrhage: a review. Thromb J. 27 nov 2021;19(1):93.
- Lee WC, Fang HY. Management of pulmonary embolism after recent intracranial hemorrhage: A case report. Medicine (Baltimore). avr 2018;97(15):e0479.
- Xian Y, Zhang S, Inohara T, Grau-Sepulveda M, Matsouaka RA, Peterson ED, et al. Clinical Characteristics and Outcomes Associated With Oral Anticoagulant Use Among Patients Hospitalized With Intracerebral Hemorrhage. JAMA Netw Open. 1 févr 2021;4(2):e2037438.
- Flaherty ML. Anticoagulant-associated intracerebral hemorrhage. Semin Neurol. nov 2010;30(5):565-72.
- Huang XY, Zhang JY, Yu CY. Whether it is safe to start anticoagulation after intracranial hemorrhage within 2 weeks: A systematic review and meta-analysis. Ibrain. 2022;8(3):377-88.
- Pennlert J, Overholser R, Asplund K, Carlberg B, Van Rompaye B, Wiklund PG, et al. Optimal Timing of Anticoagulant Treatment After Intracerebral Hemorrhage in Patients With Atrial Fibrillation. Stroke. févr 2017;48(2):314-20.
- Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing GJ, Harjola VP, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 21 janv 2020;41(4):543-603.
- Lecumberri R, Jiménez L, Ruiz-Artacho P, Nieto JA, Ruiz-Giménez N, Visonà A, et al. Prediction of Major Bleeding in Anticoagulated Patients for Venous Thromboembolism: Comparison of the RIETE and the VTE-BLEED Scores. TH Open. juill 2021;5(3):e319-28.
- Tsujisaka Y, Yamashita Y, Morimoto T, Takase T, Hiramori S, Kim K, et al. Application of the RIETE score to identify low-risk patients with pulmonary embolism: From the COMMAND VTE Registry. Thromb Res. déc 2023;232:35-42.
- Oneglia C, Gualeni A. Pulmonary embolism after brain hemorrhage in a hypertensive patient: the therapeutic dilemma. J Thromb Thrombolysis. avr 2008;25(2):231-4.
- Cuker A, Burnett A, Triller D, Crowther M, Ansell J, Van Cott EM, et al. Reversal of direct oral anticoagulants: Guidance from the Anticoagulation Forum. Am J Hematol. juin 2019;94(6):697-709.
- Roland Veltkamp, Solveig Horstmann. Treatment of intracerebral hemorrhage associated with new oral anticoagulant use: the neurologist’s view. Clinics in laboratory medicine [Internet]. Sept 2014. Disponible sur: https://pubmed.ncbi.nlm.nih.gov/25168944/
References
Becattini C, Cimini LA, Carrier M. Challenging anticoagulation cases: A case of pulmonary embolism shortly after spontaneous brain bleeding. Thromb Res. avr 2021;200:41-7.
Cai Q, Zhang X, Chen H. Patients with venous thromboembolism after spontaneous intracerebral hemorrhage: a review. Thromb J. 27 nov 2021;19(1):93.
Lee WC, Fang HY. Management of pulmonary embolism after recent intracranial hemorrhage: A case report. Medicine (Baltimore). avr 2018;97(15):e0479.
Xian Y, Zhang S, Inohara T, Grau-Sepulveda M, Matsouaka RA, Peterson ED, et al. Clinical Characteristics and Outcomes Associated With Oral Anticoagulant Use Among Patients Hospitalized With Intracerebral Hemorrhage. JAMA Netw Open. 1 févr 2021;4(2):e2037438.
Flaherty ML. Anticoagulant-associated intracerebral hemorrhage. Semin Neurol. nov 2010;30(5):565-72.
Huang XY, Zhang JY, Yu CY. Whether it is safe to start anticoagulation after intracranial hemorrhage within 2 weeks: A systematic review and meta-analysis. Ibrain. 2022;8(3):377-88.
Pennlert J, Overholser R, Asplund K, Carlberg B, Van Rompaye B, Wiklund PG, et al. Optimal Timing of Anticoagulant Treatment After Intracerebral Hemorrhage in Patients With Atrial Fibrillation. Stroke. févr 2017;48(2):314-20.
Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing GJ, Harjola VP, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 21 janv 2020;41(4):543-603.
Lecumberri R, Jiménez L, Ruiz-Artacho P, Nieto JA, Ruiz-Giménez N, Visonà A, et al. Prediction of Major Bleeding in Anticoagulated Patients for Venous Thromboembolism: Comparison of the RIETE and the VTE-BLEED Scores. TH Open. juill 2021;5(3):e319-28.
Tsujisaka Y, Yamashita Y, Morimoto T, Takase T, Hiramori S, Kim K, et al. Application of the RIETE score to identify low-risk patients with pulmonary embolism: From the COMMAND VTE Registry. Thromb Res. déc 2023;232:35-42.
Oneglia C, Gualeni A. Pulmonary embolism after brain hemorrhage in a hypertensive patient: the therapeutic dilemma. J Thromb Thrombolysis. avr 2008;25(2):231-4.
Cuker A, Burnett A, Triller D, Crowther M, Ansell J, Van Cott EM, et al. Reversal of direct oral anticoagulants: Guidance from the Anticoagulation Forum. Am J Hematol. juin 2019;94(6):697-709.
Roland Veltkamp, Solveig Horstmann. Treatment of intracerebral hemorrhage associated with new oral anticoagulant use: the neurologist’s view. Clinics in laboratory medicine [Internet]. Sept 2014. Disponible sur: https://pubmed.ncbi.nlm.nih.gov/25168944/