급성 심근경색으로 인한 심정지 환자에게 소생 후 치료 중 사용된 Enoxaparin에의해 발생한 다발성 대뇌출혈 1례|RISS 상세보기

다국어 초록 (Multilingual Abstract)

We report a rare case of multiple intracerebral hemorrhage,
subarachnoid hemorrhage, and intraventricular hemorrhage
that developed after successful cardiopulmonary resuscitation
(CPR). A 66-year-old man underwent CPR for about 10
minutes in his community hospital. At that time, his only
sequela was ST depression in leads V3, and V4 with an
ECG. There was no definite parenchymal lesion in the brain
computed tomography (CT) scan taken in the community
hospital, and the patient was transferred to Wonju christian
hospital for post-resuscitation management. Upon arrival,
echocardiographic findings showed akinesia of the anterior
wall and anteroseptal wall together with decreased ejection
fraction (34%). A cardiac enzyme assay showed a CK-MB
concentration of 19.4 ng/ml and a troponin-I level of 1.66
ng/ml. He was mentally comatose and both pupils were
isocoric and reflexive to light. We concluded that the cause
of cardiac arrest was acute myocardial infarction (AMI),
and the patient was treated with drugs including aspirin,
clopidogrel, enoxaparin-sodium (1 mg/kg subcutaneous),
and isosorbide dinitrate. At 10 hours after admission, a follow-
up ECG showed ST elevation in lead I, aVL and all
leads from V1 to V6. Right anisocoria was seen in neurologic
examination at that time. A subsequent brain CT
revealed multiple intracerebral hemorrhage, subarachnoid
hemorrhage into all cisternal spaces, and intraventricular
hemorrhage. Clotting evaluations yielded a prothrombin
time (PT) of 14.6 sec., partial thromboplastin time (PTT) of
45.3 sec. and an INR of 1.32, and a hemoglobin count of
16.2 g/dL.

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참고문헌 (Reference)

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