Clinical Medicine Insights: Geriatrics 2015:8 7-10
Case report
Published on 27 Aug 2015
DOI: 10.4137/CMGer.S28033
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In patients with a mechanical heart valve, adequate anticoagulation is extremely important, as coagulation poses a risk of embolism and thrombosis of the valve. However, in patients with a metallic heart valve suffering an intracranial bleed, there is a high mortality rate. This can become a management dilemma, as limited evidence is available to guide clinical decision-making in this situation. Each case must be assessed individually, ideally with a multidisciplinary team approach. Here, we report the case of a woman in her 80s presenting with acute massive subdural hemorrhage because of a fall. We examine the complex repercussions of specific decisions in a very critical clinical scenario. Furthermore, we suggest that a revision of anticoagulation guidelines may be necessary.
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