Key result
Untreated VTE leads to fatal massive PE during craniotomy for intracerebral hemorrhage.
Why the study?
Venous thrombosis is a common complication in critically ill patients with intracerebral hemorrhage that may lead to pulmonary embolism, highlighting the need for effective prophylactic and therapeutic strategies.
Case Report (n=1)
No
This case highlights the risks of thromboembolic events in critically ill patients with intracerebral hemorrhage and the utility of perioperative ultrasound.
Fatal PE during craniotomy in ICH with untreated VTE warrants perioperative vigilance; single case leaves optimal prophylaxis unresolved.
Background: Venous thrombosis is a common complication among critically ill patients with intracerebral hemorrhage, which may lead to pulmonary embolism. Case Presentation: In this report, we present a case of a man who was diagnosed with left basal ganglia region hemorrhage, hypertension, and venous thromboembolism. Considering the risks, including rebleeding and the expansion of the hematoma, he did not receive any anticoagulation after onset. The thrombus located in the pulmonary artery was found by transesophageal echocardiography after he suffered cardiac arrest during the craniotomy. Additionally, a thrombus attached to the central venous catheter was observed by ultrasound. Unfortunately, he died of PE without receiving any effective treatment. Conclusions: This case emphasizes the importance of prophylactic and therapeutic strategies for thromboembolic events among critically ill populations. It also underscores the critical role of perioperative ultrasound.
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He et al. (2023) conducted a case report in Acute massive pulmonary embolism (n=1). Craniotomy without anticoagulation was evaluated on Death due to pulmonary embolism. A 59-year-old man with intracerebral hemorrhage and untreated venous thromboembolism suffered a fatal acute massive pulmonary embolism during a craniotomy.
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