One disadvantage of direct anticoagulant drug is the lack of an antidote, which may become relevant in patients with traumatic brain in- jury. A 77-years old man with atrial fibrillation and syncope received dabigatra...One disadvantage of direct anticoagulant drug is the lack of an antidote, which may become relevant in patients with traumatic brain in- jury. A 77-years old man with atrial fibrillation and syncope received dabigatran despite recurrent falls. Due to a ground-level-fall, he suffered from subarachnoidal and intraparenchymal hemorrhages, subdural hematoma and brain edema with a midline shift. Despite osteoelast/c trepanation and hematoma-evacuation he remained comatose and died seven days later without regaining consciousness. Most probably, decreased dabigatran clearance due to increased age might have contributed to the fatal course. We suggest withholding anticoagulant therapy in patients with unexplained falls. If anticoagulant therapy is deemed necessary, vitamin-K-antagonists with their potential for laboratory monitoring and reversal of anticoagulant activity should be preferred.展开更多
To the Editor: With interest, we read the article by Su et al[1] about the antiepileptic drug (AED) treatment of 17 patients with genetically confirmed myoclonic epilepsy with ragged-red fibers (MERRF) syndrome. It wa...To the Editor: With interest, we read the article by Su et al[1] about the antiepileptic drug (AED) treatment of 17 patients with genetically confirmed myoclonic epilepsy with ragged-red fibers (MERRF) syndrome. It was found that monotherapy with either levetiracetam (LEV), clonazepam (CZP), valproic acid (VPA).展开更多
To the Editor:With interest,we read the article by Xu et al[1]about a 54-year old man with a multisystem mitochondrial disorder(MID)affecting the brain,ears,and muscle.Clinical manifestations were attributed to the va...To the Editor:With interest,we read the article by Xu et al[1]about a 54-year old man with a multisystem mitochondrial disorder(MID)affecting the brain,ears,and muscle.Clinical manifestations were attributed to the variant m.8363G>A in tRNA(Lys).[1]We have the following comments and concerns.展开更多
We read with interest the case report by Ban et al. about a 17-year-old male with myoclonic epilepsy with ragged red fibers （MERRF） syndrome being attributed to the mitochondrial tRNA glutamic acid （tRNA [Glu]） va...We read with interest the case report by Ban et al. about a 17-year-old male with myoclonic epilepsy with ragged red fibers （MERRF） syndrome being attributed to the mitochondrial tRNA glutamic acid （tRNA [Glu]） variant mitochondrial 14709T〉C. The authors claimed that the variant occurred sporadically and has not been reported in association with a MERRF phenotype so far. We have the following comments and concerns.展开更多
文摘One disadvantage of direct anticoagulant drug is the lack of an antidote, which may become relevant in patients with traumatic brain in- jury. A 77-years old man with atrial fibrillation and syncope received dabigatran despite recurrent falls. Due to a ground-level-fall, he suffered from subarachnoidal and intraparenchymal hemorrhages, subdural hematoma and brain edema with a midline shift. Despite osteoelast/c trepanation and hematoma-evacuation he remained comatose and died seven days later without regaining consciousness. Most probably, decreased dabigatran clearance due to increased age might have contributed to the fatal course. We suggest withholding anticoagulant therapy in patients with unexplained falls. If anticoagulant therapy is deemed necessary, vitamin-K-antagonists with their potential for laboratory monitoring and reversal of anticoagulant activity should be preferred.
文摘To the Editor: With interest, we read the article by Su et al[1] about the antiepileptic drug (AED) treatment of 17 patients with genetically confirmed myoclonic epilepsy with ragged-red fibers (MERRF) syndrome. It was found that monotherapy with either levetiracetam (LEV), clonazepam (CZP), valproic acid (VPA).
文摘To the Editor:With interest,we read the article by Xu et al[1]about a 54-year old man with a multisystem mitochondrial disorder(MID)affecting the brain,ears,and muscle.Clinical manifestations were attributed to the variant m.8363G>A in tRNA(Lys).[1]We have the following comments and concerns.
文摘We read with interest the case report by Ban et al. about a 17-year-old male with myoclonic epilepsy with ragged red fibers （MERRF） syndrome being attributed to the mitochondrial tRNA glutamic acid （tRNA [Glu]） variant mitochondrial 14709T〉C. The authors claimed that the variant occurred sporadically and has not been reported in association with a MERRF phenotype so far. We have the following comments and concerns.
