Context/Objective: Deep venous thrombosis (DVT) is a well-known complication of an acute spinal cord injury (SCI). However, the prevalence of DVT in patients with chronic SCI has only been reported in a limited number of studies. The aim of our study was to examine the prevalence of DVT in patients with SCI beyond three months after injury. Design: Cross-sectional study. Setting: Rehabilitation Department at the Bydgoszcz University Hospital in Poland. Participants: Sixty-three patients with SCI that were more than 3 months post injury. The patients, ranging in age from 13 to 65 years, consisted of 15 women and 48 men; the mean age of the patients was 32.1 years. The time from injury varied from 4 to 124 months. Outcome measures: Clinical assessment, D-dimer and venous duplex scan. Results: The venous duplex scan revealed DVT in 5 of the 63 patients. The post-injury time in four of the patients varied between 4 and 5 months; one patient was 42 months post-injury. Conclusion: DVT occurred in patients with chronic SCI, mainly by the 6th post injury month.

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Patients with spinal cord injury (SCI) are at an increased risk of deep vein thrombosis (DVT). This study aims at assessing usefulness of D-dimer and compressive Doppler ultrasonography (CDUS) for detecting DVT in patients undergoing rehabilitation at various time-points post-SCI. One-hundred forty-five patients were divided into three groups based on time elapsed since SCI: I (≥3 weeks to 3 months), II (≥3 to 6 months), and III (≥6 months). On admission, D-dimer plasma level measurement and CDUS of the lower limbs venous system were performed. DVT was diagnosed using CDUS in 15 patients (10.3% of entire group), more frequently in group I (22.2% of group) and II (11.7%) compared to group III (1.5%). Most DVT patients received thromboprophylaxis (80%) and were asymptomatic or mildly symptomatic (60%). Median D-dimer was elevated in patients with DVT from all groups, and also patients without DVT from groups I and II, but not group III. D-dimers were higher in patients with DVT than without DVT in the entire group (p = 0.001) and group I (p = 0.02), but not in groups II and III. The risk of DVT in SCI patients undergoing rehabilitation and thromboprophylaxis including asymptomatic or mildly symptomatic cases, is high within 6 months post-injury, and especially within 3 months. Measurement of D-dimer level should be complemented by routine CDUS for detecting DVT within 6 months post-SCI. Over 6 months, the usefulness of D-dimer screening alone is better for DVT detection.

Objective: The goal of this study was to measure hemostatic markers after SCI. Design: Assesing changes in coagulation and fibrynilitic system in SCI patients in different time post injury to Cross-sectional study.

Background: Patients with spinal cord injury (SCI) exhibit hemostasis disorders. This study aims at assessing the effects of a 4-week rehabilitation program on hemostasis disorders in patients with SCI. Methods: Seventy-eight in-patients undergoing a 4-week rehabilitation were divided into three groups based on time elapsed since SCI: I (3 weeks–3 months), II (3–6 months), and III (>6 months). Tissue factor (TF), tissue factor pathway inhibitor (TFPI), thrombin–antithrombin complex (TAT) and D-dimer levels, antithrombin activity (AT), and platelet count (PLT) were measured on admission and after rehabilitation. Results: Rehabilitation resulted in an increase in TF in group III (p < 0.050), and decrease in TFPI (p < 0.022) and PLT (p < 0.042) in group II as well as AT in group I (p < 0.009). Compared to control group without SCI, TF, TFPI, and TAT were significantly higher in all SCI groups both before and after rehabilitation. All SCI groups had elevated D-dimer, which decreased after rehabilitation in the whole study group (p < 0.001) and group I (p < 0.001). Conclusion: No decrease in activation of TF-dependent coagulation was observed after a 4-week rehabilitation regardless of time elapsed since SCI. However, D-dimer levels decreased significantly, which may indicate reduction of high fibrinolytic potential, especially when rehabilitation was done <3 months after SCI.

The risk of venous thromboembolic (VTE) complications, mainly in the form of pulmonary embolism (PE) and deep vein thrombosis (DVT), in COVID-19 is well known, necessitating the administration of thrombotic prophylaxis in most patients. With a high risk of VTE complications or their presence, full anticoagulation may be associated with hemorrhagic complications. COVID-19 bleeding is rarely reported. Here, we present four cases of patients with muscle bleeding: two in the iliopsoas muscle, which resulted in death despite the embolization of the bleeding vessel, and two in the oblique and straight abdominal muscles, which were treated conservatively. In the reported cases, the severity of the bleeding coincided with the severity of the course of COVID-19. When observing a sudden drop in hemoglobin (Hb) in a patient with COVID-19, one must always remember the possible complications in the form of muscle bleeding, which can be fatal.

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Posterior reversible encephalopathy syndrome (PRES) is a rare complication that the exact pathophysiological mechanism of which is still unclear. PRES most often occurs in connection with severe hypertension and autoimmune diseases. It can also appear during chemotherapy or immunosuppressive treatment. A 38-year-old woman with a negative medical history was admitted to the local hospital due to loss of consciousness accompanied by seizures and high values of blood pressure, and a PCR test for COVID-19 was positive. The patient’s condition was preceded by weakness, wet cough, runny nose, and low-grade fever for three days. Due to the conducted diagnostics after negative CT scans and angio CT studies, an MRI of the head with contrast was performed, where changes characteristic of PRES syndrome were found. During the hospitalization, the patient did not require invasive ventilation and did not receive antiviral drugs or tocilizumab as a result of treatment for her high blood pressure values, and after establishing the diagnosis, the patient was discharged home with a significant improvement in her well-being. In the literature, there are discussions as to whether COVID-19 predisposes patients to PRES. Isolated cases have been described, but its frequency is not yet established. Case reports in the literature appear to be specifically associated with a severe course of the disease, unlike in our patient. Even with a mild course of COVID, the diagnosis of PRES should be taken into account in patients with seizures, visual disturbances, or other focal neurological deficits.