Administration of high-dose four-factor prothrombin complex concentrate for Xa inhibitor reversal to prevent expansion of intracranial hemorrhage with computed tomography angiography spot sign: a case report

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  • CTA spot sign を有するXa 阻害薬内服患者の脳出血に対して高用量の4factor-prothrombin complex concentrate（4F-PCC）を投与した1 例

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Abstract

<p>A 69-year-old woman presented with consciousness disturbance, and she was admitted to our hospital. She had taken a Xa inhibitor (rivaroxaban) for non-valvular atrial fibrillation. Head computed tomography revealed a large subcortical hemorrhage in the left temporal lobe and uncal herniation. Computed tomography angiography revealed a spot sign in the hematoma. To prevent hematoma expansion, we administered a high-dose four-factor prothrombin complex concentrate (4F-PCC). Immediately after 4F-PCC administration, her prothrombin time (PT) and PT-INR completely normalized. Subsequently, we performed craniotomy and evacuated the hematoma. After the surgery, her consciousness disturbance completely resolved. Eventually, she was transferred to a rehabilitation hospital owing to cognitive dysfunction.</p>

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