Time of onset at 8 a.m. on October 23, he drove himself to the hospital for treatment in time. He went to the emergency department for head CT, lung CT, head enhancement CT and so on. He was admitted to the ward at about 4 p.m. today, the results of MRI have come out. I want to ask the doctor if there is a thrombus in the vein of my father's lower limbs that needs to be dissolved. I want to ask if the hemolytic thrombus is life-threatening, and what is the probability of brain bleeding again. Is thrombolysis necessary in this case solution
Condition Analysis:
Lower extremity venous thrombosis is generally not thrombolytic therapy, but the first choice of anticoagulant therapy, that is, anticoagulant therapy with anticoagulant drugs (commonly used drugs include warfarin, rivaroxaban, dabigatran, low molecular weight heparin, etc.). The biggest risk of anticoagulant therapy is bleeding, such as cerebral hemorrhage, gastrointestinal bleeding, urethral bleeding, etc. severe bleeding will also endanger life, which is very contradictory, but for ordinary patients, The risk of anticoagulant treatment of bleeding is not large. Combined with your father's magnetic resonance imaging, I think the risk of bleeding is relatively high. On the one hand, it is easy to bleed in the acute stage of cerebral infarction. On the other hand, there are multiple brain atrophy and hemosiderin deposition in the basal ganglia (it may be bleeding bit by bit at ordinary times). Combined with these two points, anticoagulant treatment of intracranial hemorrhage has a higher risk. Treatment opinions: ① if there are more venous thrombosis in lower limbs and serious paralysis, the risk of increased thrombosis is also very high. It is recommended to use low-dose anticoagulant drugs, which is less than the normal dosage. However, as a family member, you need to fully understand the risk of bleeding. In case of bleeding after low-dose use, can you accept it? If not, don't use it. ② Minimally invasive interventional surgery can be done, and a filter can be installed in the inferior vena cava to avoid the longer the lower limb thrombosis, the more it runs into the lung to form pulmonary embolism. However, it can only be taken out after 2-3 weeks, just as a transitional method.
Condition Analysis:
Hello, now this situation is more recommended to carry out relevant symptomatic treatment, because there has been this infarction, so we must be more vigilant, and then there is this infarction problem, which needs more attention. Then if there is this thrombus, thrombolytic therapy should be carried out.
Condition Analysis:
If it is in the acute stage of cerebral infarction, thrombolytic therapy can be carried out, but if it cannot be dissolved beyond a certain time, thrombolysis does have many complications. For example, intracranial hemorrhage is its most serious complication. There is no data to show the probability of bleeding after thrombolysis. Even if there is, it has little guiding significance, because everyone's situation is different, and the probability of bleeding is also different
