Journal de colonne vertébrale et de neurochirurgie

Delayed Traumatic Subarachnoid Hemorrhage Related to Anticoagulant Use: A Case Report

Arai N, Tabuse M, Nakamura A and Miyazaki H

Delayed intracranial hemorrhage is dangerous and not so rare. To prevent such an exacerbation, head trauma patients taking anticoagulants is recommended 24-48 hour observational admission despite of normal CT. Among delayed intracranial hemorrhage, delayed traumatic subarachnoid hemorrhage (DTSAH) is rare. Here, we show 82-year-old woman presented with head injury. She was alert and no abnormality was detected in initial CT. Four days after that she came again due to vertigo. The CT showed subarachnoid hemorrhage in sylvian fissure. She had atrium fibriation and anticoagulant. We experienced an infrequent DTSAH with anticoagulant. The appearance of symptom was delayed notably 96 hours. Clinicians should be aware that DTSAH can occur much later than previous studies about delayed intracranial hemorrhage expected and check coagulation despite no drug information.