Delayed Traumatic Subarachnoid Hemorrhage in a Polytraumatized Patient with Disseminated Intravascular Coagulation
The precise mechanism involved in DIC and delayed traumatic subarachnoid hemorrhage (DT-SAH) remains unclear in multipletrauma patients. Hereby, we describe a polytraumatized patient with DIC who died due to DT-SAH. A 75-year-old female patient was admitted to our Emergency Department complaining of...
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doaj-b6ebe86f9b4d447aabc4e3adb865a68c2020-11-24T22:23:39ZengKorean Society of Critical Care MedicineKorean Journal of Critical Care Medicine2383-48702383-48892015-11-0130433634210.4266/kjccm.2015.30.4.33635Delayed Traumatic Subarachnoid Hemorrhage in a Polytraumatized Patient with Disseminated Intravascular CoagulationJiwoong Oh0Wonyeon Lee1Ji Young Jang2Pilyoung Jung3Sohyun Kim4Jongyeon Kim5Jinsu Pyen6Kum Whang7Sungmin Cho8 Department of Neurosurgery, Wonju College of Medicine, Yonsei University, Wonju, Korea Department of Pulmonology, Wonju College of Medicine, Yonsei University, Wonju, Korea Department of Surgery, Trauma Center, Wonju Severance Christian Hospital, Yonsei University, Wonju, Korea Department of Surgery, Trauma Center, Wonju Severance Christian Hospital, Yonsei University, Wonju, Korea Department of Neurosurgery, Wonju College of Medicine, Yonsei University, Wonju, Korea Department of Neurosurgery, Wonju College of Medicine, Yonsei University, Wonju, Korea Department of Neurosurgery, Wonju College of Medicine, Yonsei University, Wonju, Korea Department of Neurosurgery, Wonju College of Medicine, Yonsei University, Wonju, Korea Department of Neurosurgery, Wonju College of Medicine, Yonsei University, Wonju, KoreaThe precise mechanism involved in DIC and delayed traumatic subarachnoid hemorrhage (DT-SAH) remains unclear in multipletrauma patients. Hereby, we describe a polytraumatized patient with DIC who died due to DT-SAH. A 75-year-old female patient was admitted to our Emergency Department complaining of abdominal pain and drowsiness after a pedestrian accident. Her initial brain computerized tomography (CT) finding was negative for intracranial injury. However, her abdominal CT scan revealed a collection of retroperitoneal hematomas from internal iliac artery bleeding after a compressive pelvic fracture. This event eventually resulted in shock and DIC. An immediate angiographic embolization of the bleeding artery was performed along with transfusion and antithrombin III. Her vital signs were stabilized without neurological change. Fourteen hours after admission, she suddenly became comatose, and her follow-up brain CT scan revealed a dense DT-SAH along the basal cisterns with acute hydrocephalus. This event rapidly prompted brain CT angiography and digital subtraction angiography, which both confirmed the absence of any cerebrovascular abnormality. Despite emergency extraventricular drainage to reverse the hydrocephalus, the patient died three days after the trauma. This paper presents an unusual case of DT-SAH in a polytraumatized patient with DIC.http://kjccm.org/upload/pdf/kjccm-2015-30-4-336.pdfdisseminated intravascular coagulationpolytraumataumatic subarachnoid hemorrhage |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jiwoong Oh Wonyeon Lee Ji Young Jang Pilyoung Jung Sohyun Kim Jongyeon Kim Jinsu Pyen Kum Whang Sungmin Cho |
spellingShingle |
Jiwoong Oh Wonyeon Lee Ji Young Jang Pilyoung Jung Sohyun Kim Jongyeon Kim Jinsu Pyen Kum Whang Sungmin Cho Delayed Traumatic Subarachnoid Hemorrhage in a Polytraumatized Patient with Disseminated Intravascular Coagulation Korean Journal of Critical Care Medicine disseminated intravascular coagulation polytrauma taumatic subarachnoid hemorrhage |
author_facet |
Jiwoong Oh Wonyeon Lee Ji Young Jang Pilyoung Jung Sohyun Kim Jongyeon Kim Jinsu Pyen Kum Whang Sungmin Cho |
author_sort |
Jiwoong Oh |
title |
Delayed Traumatic Subarachnoid Hemorrhage in a Polytraumatized Patient with Disseminated Intravascular Coagulation |
title_short |
Delayed Traumatic Subarachnoid Hemorrhage in a Polytraumatized Patient with Disseminated Intravascular Coagulation |
title_full |
Delayed Traumatic Subarachnoid Hemorrhage in a Polytraumatized Patient with Disseminated Intravascular Coagulation |
title_fullStr |
Delayed Traumatic Subarachnoid Hemorrhage in a Polytraumatized Patient with Disseminated Intravascular Coagulation |
title_full_unstemmed |
Delayed Traumatic Subarachnoid Hemorrhage in a Polytraumatized Patient with Disseminated Intravascular Coagulation |
title_sort |
delayed traumatic subarachnoid hemorrhage in a polytraumatized patient with disseminated intravascular coagulation |
publisher |
Korean Society of Critical Care Medicine |
series |
Korean Journal of Critical Care Medicine |
issn |
2383-4870 2383-4889 |
publishDate |
2015-11-01 |
description |
The precise mechanism involved in DIC and delayed traumatic subarachnoid hemorrhage (DT-SAH) remains unclear in multipletrauma patients. Hereby, we describe a polytraumatized patient with DIC who died due to DT-SAH. A 75-year-old female patient was admitted to our Emergency Department complaining of abdominal pain and drowsiness after a pedestrian accident. Her initial brain computerized tomography (CT) finding was negative for intracranial injury. However, her abdominal CT scan revealed a collection of retroperitoneal hematomas from internal iliac artery bleeding after a compressive pelvic fracture. This event eventually resulted in shock and DIC. An immediate angiographic embolization of the bleeding artery was performed along with transfusion and antithrombin III. Her vital signs were stabilized without neurological change. Fourteen hours after admission, she suddenly became comatose, and her follow-up brain CT scan revealed a dense DT-SAH along the basal cisterns with acute hydrocephalus. This event rapidly prompted brain CT angiography and digital subtraction angiography, which both confirmed the absence of any cerebrovascular abnormality. Despite emergency extraventricular drainage to reverse the hydrocephalus, the patient died three days after the trauma. This paper presents an unusual case of DT-SAH in a polytraumatized patient with DIC. |
topic |
disseminated intravascular coagulation polytrauma taumatic subarachnoid hemorrhage |
url |
http://kjccm.org/upload/pdf/kjccm-2015-30-4-336.pdf |
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