Spontaneous subdural haematoma in a patient with a total artificial heart on warfarin. Issue 9 (4th September 2019)

• Record Type: Journal Article
• Authors: Moledina, Saadiq; Shanmuganathan, Mayooran; Pathak, Suraj; Simon, Andre
• Is Part Of: BMJ case reports. Volume 12:Issue 9(2019)
• Publication Date: 2019-09-04
• Subjects: heart failure -- interventional cardiology -- radiology (diagnostics); Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2019-230519
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : We present the unusual case of a middle-aged woman who developed a spontaneous subdural haematoma (SSH) while on oral anticoagulation therapy for a total artificial heart (TAH). Headache was followed by paraesthesia and numbness of the left hand. The diagnosis was made from a CT scan. Symptoms resolved with conservative management and careful control of anticoagulation. In this case report, the risk factors and pathophysiology behind this condition are explored. TAHs in their own entity are a rare phenomenon. Coupled with the highly unusual presentation of an SSH in which only a few cases have been documented, we hope to highlight the management of such a difficult case. After navigating this complication, we were able to successfully bridge this patient to a heart transplant 26 days after the SSH.