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Unusual association of diseases/symptoms
CASE REPORT
Spontaneous intracerebral haemorrhage: a rare complication of aortic aneurysm endoleak
  1. Neal Kerr1,
  2. Jasmin Kerr2,
  3. James M Faed3,
  4. Jo Krysa4
  1. 1Neurosurgery, Dunedin Hospital, Dunedin, New Zealand
  2. 2Internal Medicine, Dunedin Hospital, Dunedin, New Zealand
  3. 3Haematology, Dunedin Hospital, Dunedin, New Zealand
  4. 4Vascular Surgery, Dunedin Hospital, Dunedin, New Zealand
  1. Correspondence to Dr Neal Kerr, drneal.kerr{at}gmail.com

Summary

We present a rare case of intracerebral haemorrhage secondary to consumptive coagulopathy in relation to ongoing endoleak after thoracic endovascular aneurysm repair (TEVAR). A 68-year-old man underwent elective TEVAR for an 18 cm diameter Crawford type II thoracoabdominal aneurysm. He was subsequently shown to have a type 1b endoleak and a short episode of disseminated intravascularcoagulation (DIC) perioperatively. Two months after the procedure, he experienced a consumptive coagulopathy leading to intracerebral haemorrhage and ultimately his death. Endoleak-related DIC is an underappreciated phenomenon within the medical literature. Currently, management is reliant on general DIC principles and anecdotal experiences of others within the case report literature.

  • haematology (incl blood transfusion)
  • stroke
  • interventional radiology
  • vascular surgery

https://doi.org/10.1136/bcr-2018-225249

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    Footnotes

    • Contributors NK: review of case notes and investigations. Main author. Draft review. Literature review. JaK: literature review. Draft review. Formatting. JoK: draft review. Vascular background and discussion. JF: draft review. Haematology background and discussion.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Next of kin consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.