acenocoumarol and Craniocerebral-Trauma

Statistically 10% of head and neek trauma is caused by animal bite, more often inflicted by dogs. More than 50% of victims are infants and small children. Generally, the result of dogbite is superficial trauma but there are cases of deep soft tissue defects with amputation and multiple bone fractures. In case described in this article, an elderly woman suffered a dog attack, wich resulted in extensive face and head injuries. In spite of receiving proper treatment, the patient passed away. It is highly probable that underlying Syncumar therapy caused complications which contributed to the fatal outcome. Because of it's unusual nature we found this case to be of interest for publication.

Topics: Acenocoumarol; Aged; Animals; Anticoagulants; Bites and Stings; Craniocerebral Trauma; Dogs; Emergency Service, Hospital; Facial Bones; Facial Injuries; Fatal Outcome; Female; Hematoma, Subdural; Humans; Plastic Surgery Procedures; Skull Fractures

Over the period 1994-1998, five patients presenting coagulation status impairment in the course of sintrom treatment are hospitalized in the Clinic of Emergency Neurology and Neurosurgery. Three of them are with craniocerebral trauma (2 severe forms--score 5 by the Glasgow Coma Rating scale, and one mild form--score 15), one has spontaneous intracerebral hematoma, and one--acute hydrocephalus against the background of ruptured aneurysm of the basilar artery (score 4). Three patients are given sintrom treatment because of rheumatic heart disease (2 with mitral valve prosthetic replacement and one in the post-commissurotomy period), and two--because of absolute arrhythmia, complicated by systemic emboli in the extremities and/or pulmonary artery. Four patients are subjected to operation--2 with craniocerebral injury, one with intracerebral hematoma and one with acute hydrocephalus of which in two cases the outcome is fatal. One female patient presenting serious craniocerebral trauma is not operated (refusal by the relatives) and dies. The therapeutic approach to this contingent of patients is comprehensively discussed.

Topics: Acenocoumarol; Aged; Anticoagulants; Brain; Craniocerebral Trauma; Female; Humans; Intracranial Hemorrhages; Male; Middle Aged; Tomography, X-Ray Computed