Anticoagulants

Publication Title: 
Journal of Manipulative and Physiological Therapeutics

Subdural hematoma formation should be considered as a diagnosis in the patient who complains of headache and is on long-term anticoagulant therapy. Three such cases are described and the proper medical management is discussed.

Author(s): 
Quon, J. A.
Thiel, H. W.
Cassidy, J. D.
Donat, J. R.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: To describe a case of dissection of the postero-inferior cerebellar artery (PICA) after cervical manipulation. CLINICAL FEATURES: After cervical manipulation, a 42-year-old woman had a cerebellar syndrome related to an infarct in the area supplied by the PICA, confirmed by computed tomography of the brain. Cerebral angiography showed a normal appearance of the vertebral artery, a cervical extradural origin of PICA, and a dissection of the latter at the C1-C2 level. INTERVENTION AND OUTCOME: Anticoagulant treatment with heparin was implemented.

Author(s): 
Sédat, J.
Dib, M.
Mahagne, M. H.
Lonjon, M.
Paquis, P.
Publication Title: 
Neurology

Cervical artery dissection (CAD) recurrences are rare but the risk could be higher during the first month. Twenty-seven consecutive patients admitted for an acute CAD were investigated using a standardized imaging protocol. An early asymptomatic recurrence was observed in three patients 49 to 53 days after the initial diagnosis. Anticoagulation was maintained and the prognosis remained good. Early CAD recurrences may have been underestimated previously, because asymptomatic recurrences seem to be more frequent than symptomatic ones.

Author(s): 
Touzé, E.
Oppenheim, C.
Zuber, M.
Méary, E.
Meder, J. F.
Mas, J. L.
Publication Title: 
The Mount Sinai Journal of Medicine, New York

The clinical association between carotid artery dissection and oculosympathetic palsy is well-known. However, the occurrence of this combination with chiropractic manipulation of the cervical neck is rare. We describe the case of a 54-year-old Caucasian American male who underwent cervical manipulation for neck pain. The following day he noticed drooping of his left eyelid, with an unequal pupil size. Imaging later confirmed carotid artery dissection.

Author(s): 
Khan, Amir M.
Ahmad, Nissar
Li, Xe
Korsten, Mark A.
Rosman, Alan
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: To describe a case of dissection of the postero-inferior cerebellar artery (PICA) after cervical manipulation. CLINICAL FEATURES: After cervical manipulation, a 42-year-old woman had a cerebellar syndrome related to an infarct in the area supplied by the PICA, confirmed by computed tomography of the brain. Cerebral angiography showed a normal appearance of the vertebral artery, a cervical extradural origin of PICA, and a dissection of the latter at the C1-C2 level. INTERVENTION AND OUTCOME: Anticoagulant treatment with heparin was implemented.

Author(s): 
Sédat, J.
Dib, M.
Mahagne, M. H.
Lonjon, M.
Paquis, P.
Publication Title: 
Neurology

Cervical artery dissection (CAD) recurrences are rare but the risk could be higher during the first month. Twenty-seven consecutive patients admitted for an acute CAD were investigated using a standardized imaging protocol. An early asymptomatic recurrence was observed in three patients 49 to 53 days after the initial diagnosis. Anticoagulation was maintained and the prognosis remained good. Early CAD recurrences may have been underestimated previously, because asymptomatic recurrences seem to be more frequent than symptomatic ones.

Author(s): 
Touzé, E.
Oppenheim, C.
Zuber, M.
Méary, E.
Meder, J. F.
Mas, J. L.
Publication Title: 
The Mount Sinai Journal of Medicine, New York

The clinical association between carotid artery dissection and oculosympathetic palsy is well-known. However, the occurrence of this combination with chiropractic manipulation of the cervical neck is rare. We describe the case of a 54-year-old Caucasian American male who underwent cervical manipulation for neck pain. The following day he noticed drooping of his left eyelid, with an unequal pupil size. Imaging later confirmed carotid artery dissection.

Author(s): 
Khan, Amir M.
Ahmad, Nissar
Li, Xe
Korsten, Mark A.
Rosman, Alan
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: We report on the case of a patient with spinal epidural hematoma (SEH) after spinal manipulative therapy and review features of reported cases of a similar nature. CLINICAL FEATURES: The patient was undergoing Coumadin anticoagulant therapy for atrial fibrillation and presented to the chiropractor complaining of a stiff neck. After cervical manipulation, he developed paresthesia in both feet, progressing to motor deficits in all 4 extremities. He required a laminectomy and evacuation of a clot indenting the spinal cord.

Author(s): 
Whedon, James M.
Quebada, Patricia B.
Roberts, David W.
Radwan, Tarek A.
Publication Title: 
Pain Physician

BACKGROUND: Interventional pain management is a specialty that utilizes invasive procedures to diagnose and treat chronic pain. Patients undergoing these treatments may be receiving exogenous anticoagulants and antithrombotics. Even though the risk of major bleeding is very small, the consequences can be catastrophic. However, the role of antithrombotic therapy for primary and secondary prevention of cardiovascular disease to decrease the incidence of acute cerebral and cardiovascular events is also crucial.

Author(s): 
Manchikanti, Laxmaiah
Falco, Frank J. E.
Benyamin, Ramsin M.
Caraway, David L.
Kaye, Alan D.
Helm, Standiford
Wargo, Bradley W.
Hansen, Hans
Parr, Allan T.
Singh, Vijay
Swicegood, John R.
Smith, Howard S.
Schultz, David M.
Malla, Yogesh
Hirsch, Joshua A.
Publication Title: 
World journal of gastroenterology: WJG

AIM: To investigate a formalized therapeutic guideline for hyperlipidemic severe acute pancreatitis (HL-SAP). METHODS: Thirty-two consecutive patients with severe acute pancreatitis were included in the clinical trial. All of them met the following five criteria for admission to the study, namely the Atlanta classification and stratification system for the clinical diagnosis of SAP, APACHEII score more than 8, time interval for therapeutic intervention less than 72 hours after onset of the disease, serum triglyceride (TG) level 6.8 mmol/l or over, and exclusion of other etiologies.

Author(s): 
Mao, En-Qiang
Tang, Yao-Qing
Zhang, Sheng-Dao

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