Half-Dose Anticoagulation for Venous Thromboembolism and Phlegmasia Cerulea Dolens in a Patient With Recurrent Subdural Hematoma

Junfei Hu; Kelley Chan; Nirajan Adhikari; Amber Khan

doi:10.7759/cureus.18048

Half-Dose Anticoagulation for Venous Thromboembolism and Phlegmasia Cerulea Dolens in a Patient With Recurrent Subdural Hematoma

Cureus. 2021 Sep 17;13(9):e18048. doi: 10.7759/cureus.18048. eCollection 2021 Sep.

Authors

Junfei Hu¹, Kelley Chan², Nirajan Adhikari¹, Amber Khan¹

Affiliations

¹ Internal Medicine, Guthrie Robert Packer Hospital, Sayre, USA.
² Internal Medicine, Geisinger Commonwealth School of Medicine, Scranton, USA.

Abstract

Anticoagulation for venous thromboembolism (VTE) in patients with recurrent subdural hematoma (SDH) is challenging. It becomes even more challenging when the patient develops phlegmasia cerulea dolens (PCD). We present a 66-year-old female with a recent history of recurrent SDH who received half-dose heparin therapy for VTE and PCD. The patient had improvement of dyspnea and resolution of PCD after two days of treatment. She was discharged with half-dose enoxaparin. At her one-month follow-up, there was no evidence of new SDH or progression of VTE. Half-dose anticoagulation therapy should be considered in patients with recurrent SDH when anticoagulation is inevitable.

Keywords: case report; half-dose anticoagulation; phlegmasia cerulea dolens; subdural hematoma; venous thromboembolism.

Publication types

Case Reports