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Intramuscular Hematomas in Patients Receiving Prophylaxis or Anticoagulant Treatment after Spinal Cord Injury (SCI)—A Rare Complication: Description of Seven Cases and a Literature Analysis

Spinal cord injuries (SCIs) are associated with a high risk of thromboembolic complications (VTE), despite the use of antithrombotic prophylaxis in the form of low-molecular-weight heparin (LMWH). The occurrence of VTE requires, as in other diseases, full-dose antithrombotic treatment. Herein, we de...

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Autores principales: Mackiewicz-Milewska, Magdalena, Cisowska-Adamiak, Małgorzata, Szymkuć-Bukowska, Iwona, Sakwińska, Katarzyna, Domarecka, Iwona, Lewandowska, Anna, Głowacka-Mrotek, Iwona
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10136054/
https://www.ncbi.nlm.nih.gov/pubmed/37189761
http://dx.doi.org/10.3390/biomedicines11041142
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author Mackiewicz-Milewska, Magdalena
Cisowska-Adamiak, Małgorzata
Szymkuć-Bukowska, Iwona
Sakwińska, Katarzyna
Domarecka, Iwona
Lewandowska, Anna
Głowacka-Mrotek, Iwona
author_facet Mackiewicz-Milewska, Magdalena
Cisowska-Adamiak, Małgorzata
Szymkuć-Bukowska, Iwona
Sakwińska, Katarzyna
Domarecka, Iwona
Lewandowska, Anna
Głowacka-Mrotek, Iwona
author_sort Mackiewicz-Milewska, Magdalena
collection PubMed
description Spinal cord injuries (SCIs) are associated with a high risk of thromboembolic complications (VTE), despite the use of antithrombotic prophylaxis in the form of low-molecular-weight heparin (LMWH). The occurrence of VTE requires, as in other diseases, full-dose antithrombotic treatment. Herein, we describe seven cases of soft tissue hemorrhagic complications in the form of spontaneous intramuscular hematomas (SMHs) in patients after SCI undergoing rehabilitation. Four patients received anticoagulant therapy due to previously diagnosed deep vein thrombosis (DVT), and three patients received anticoagulant prophylaxis. None of the patients had a significant injury immediately before the hematoma appeared, and the only symptom was a sudden swelling of the limb without accompanying pain. The hematomas in all patients were treated conservatively. In three patients, significant decreases in hemoglobin were observed; in one patient, a blood transfusion was required for this reason. In all patients treated via anticoagulation, the anticoagulation treatment was modified at the time of diagnosis of the hematoma; in three patients, oral anticoagulants were changed to LMWH in a therapeutic dose, while in one patient, anticoagulant treatment was completely discontinued. Conclusions: Intramuscular hematomas are rare complications after SCI. Each sudden swelling of a limb requires ultrasound-based diagnostics. At the time of diagnosis of a hematoma, the level of hemoglobin and the size of the hematoma should be monitored. The treatment or anticoagulation prophylaxis should be modified if necessary.
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spelling pubmed-101360542023-04-28 Intramuscular Hematomas in Patients Receiving Prophylaxis or Anticoagulant Treatment after Spinal Cord Injury (SCI)—A Rare Complication: Description of Seven Cases and a Literature Analysis Mackiewicz-Milewska, Magdalena Cisowska-Adamiak, Małgorzata Szymkuć-Bukowska, Iwona Sakwińska, Katarzyna Domarecka, Iwona Lewandowska, Anna Głowacka-Mrotek, Iwona Biomedicines Case Report Spinal cord injuries (SCIs) are associated with a high risk of thromboembolic complications (VTE), despite the use of antithrombotic prophylaxis in the form of low-molecular-weight heparin (LMWH). The occurrence of VTE requires, as in other diseases, full-dose antithrombotic treatment. Herein, we describe seven cases of soft tissue hemorrhagic complications in the form of spontaneous intramuscular hematomas (SMHs) in patients after SCI undergoing rehabilitation. Four patients received anticoagulant therapy due to previously diagnosed deep vein thrombosis (DVT), and three patients received anticoagulant prophylaxis. None of the patients had a significant injury immediately before the hematoma appeared, and the only symptom was a sudden swelling of the limb without accompanying pain. The hematomas in all patients were treated conservatively. In three patients, significant decreases in hemoglobin were observed; in one patient, a blood transfusion was required for this reason. In all patients treated via anticoagulation, the anticoagulation treatment was modified at the time of diagnosis of the hematoma; in three patients, oral anticoagulants were changed to LMWH in a therapeutic dose, while in one patient, anticoagulant treatment was completely discontinued. Conclusions: Intramuscular hematomas are rare complications after SCI. Each sudden swelling of a limb requires ultrasound-based diagnostics. At the time of diagnosis of a hematoma, the level of hemoglobin and the size of the hematoma should be monitored. The treatment or anticoagulation prophylaxis should be modified if necessary. MDPI 2023-04-10 /pmc/articles/PMC10136054/ /pubmed/37189761 http://dx.doi.org/10.3390/biomedicines11041142 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Mackiewicz-Milewska, Magdalena
Cisowska-Adamiak, Małgorzata
Szymkuć-Bukowska, Iwona
Sakwińska, Katarzyna
Domarecka, Iwona
Lewandowska, Anna
Głowacka-Mrotek, Iwona
Intramuscular Hematomas in Patients Receiving Prophylaxis or Anticoagulant Treatment after Spinal Cord Injury (SCI)—A Rare Complication: Description of Seven Cases and a Literature Analysis
title Intramuscular Hematomas in Patients Receiving Prophylaxis or Anticoagulant Treatment after Spinal Cord Injury (SCI)—A Rare Complication: Description of Seven Cases and a Literature Analysis
title_full Intramuscular Hematomas in Patients Receiving Prophylaxis or Anticoagulant Treatment after Spinal Cord Injury (SCI)—A Rare Complication: Description of Seven Cases and a Literature Analysis
title_fullStr Intramuscular Hematomas in Patients Receiving Prophylaxis or Anticoagulant Treatment after Spinal Cord Injury (SCI)—A Rare Complication: Description of Seven Cases and a Literature Analysis
title_full_unstemmed Intramuscular Hematomas in Patients Receiving Prophylaxis or Anticoagulant Treatment after Spinal Cord Injury (SCI)—A Rare Complication: Description of Seven Cases and a Literature Analysis
title_short Intramuscular Hematomas in Patients Receiving Prophylaxis or Anticoagulant Treatment after Spinal Cord Injury (SCI)—A Rare Complication: Description of Seven Cases and a Literature Analysis
title_sort intramuscular hematomas in patients receiving prophylaxis or anticoagulant treatment after spinal cord injury (sci)—a rare complication: description of seven cases and a literature analysis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10136054/
https://www.ncbi.nlm.nih.gov/pubmed/37189761
http://dx.doi.org/10.3390/biomedicines11041142
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