Turkish Journal of Physical Medicine and Rehabilitation 2009 , Vol 55 , Num 4
Upper Extremity Deep Vein Thrombosis in a Patient with Hemorrhagic Stroke - A Case Report
Evren Yaşar 1 ,Rıdvan Alaca 2 ,İsmail Safaz 3 ,Salim Göktepe 3
1 Gülhane Askeri Tıp Akademisi, Fizik Tedavi ve Rehabilitasyon Anabilim Dalı, Türk Silahlı Kuvvetleri Rehabilitasyon Merkezi, Ankara, Türkiye
2 Gülhane Askeri Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Türk Silahlı Kuvvetleri Rehabilitasyon Merkezi, Ankara, Türkiye
3 Gülhane Askeri Tıp Akademisi Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Türk Silahlı Kuvvetleri Rehabilitasyon Merkezi, Ankara, Türkiye

In this article, we present a 55-year-old woman with hemorrhagic stroke who had upper extremity deep venous thrombosis (DVT) at the hemiplegic side and a review of the literature concerning the DVT treatment after hemorrhagic stroke. Her right upper extremity was flaccid. The passive movements of the right shoulder were painful and there was mild edema localized in her right hand. Duplex ultrasound scanning was performed to investigate any thrombosis causing edema in the right upper extremity and a thrombus in right vena basilica was determined. We administered nadroparine calcium 19,000 IUAxa daily for 10 days subcutaneously and observed that deep venous system of right upper extremity was cleared after two weeks. The use of anticoagulants in the prevention or treatment of DVT in patients with hemorrhagic stroke is potentially hazardous and there is lack of information about this issue in the literature. In our opinion, low-molecular-weight heparins may be a relatively good choice to treat upper extremity DVT and to prevent highly fatal pulmonary embolism in patients with hemorrhagic stroke. 

Keywords : Hemorrhagic stroke, upper extremity edema, deep venous thrombosis