natgillin/translations-raw huggingface dataset:
Based on literature data the use of enoxaparin sodium 4,000 IU (40 mg) in cirrhotic patients (Child-Pugh class B-C) appears to be safe and effective in preventing portal vein thrombosis.
Glede na podatke iz literature je uporaba 4.000 i.e. (40 mg) natrijevega enoksaparinata pri bolnikih s cirozo (Child-Pugh B-C) varna in učinkovita za preprečevanje portalne venske tromboze.
• If you are bleeding heavily or have a condition with a high risk of bleeding (such as stomach ulcer, recent surgery of the brain or eyes), including recent bleeding stroke.
• Če močno krvavite ali imate kakšno motnjo, ki jo spremlja veliko tveganje za krvavitev (npr. razjedo na želodcu, nedavno operacijo na možganih ali očeh), vključno z nedavno možgansko
Treatment of acute STEMI (patients over 75)
Zdravljenje akutnega STEMI (bolniki, starejši od 75 let)
• Medicinal products affecting haemostasis (see section 4.4) It is recommended that some agents which affect haemostasis should be discontinued prior to enoxaparin sodium therapy unless strictly indicated.
• Zdravila, ki vplivajo na hemostazo (glejte poglavje 4.4) Pred začetkom zdravljenja z natrijevim enoksaparinatom je priporočljivo opustiti nekatera zdravila, ki vplivajo na hemostazo, če niso strogo indicirana.
• Prednisolone, dexamethasone or other medicines used to treat asthma, rheumatoid arthritis and other conditions
• Prednizolon, deksametazon ali druga zdravila, ki se uporabljajo za zdravljenje astme, revmatoidnega artritisa in drugih bolezni.
Both enoxaparin sodium regimens were equivalent to standard heparin therapy in reducing the risk of recurrent venous thromboembolism (DVT and/or PE).
Obe shemi z natrijevim enoksaparinatom sta bili enakovredni običajnemu heparinskemu zdravljenju, kar zadeva zmanjšanje tveganja za ponovno vensko trombembolijo (GVT in/ali PE).
Bilateral venography was performed between days 25 and 31, or sooner if symptoms of venous thromboembolism occurred.
Med 25. in 31. dnem je bila opravljena obojestranska venografija; v primeru pojava simptomov venske trombembolije pa je bila lahko opravljena že prej.
Caution should be used in patients with hepatic impairment as these patients have an increased potential for bleeding (see section 4.4) and no formal dose finding studies have been performed in cirrhotic patients (Child Pugh class A, B nor C).
Pri bolnikih z okvaro jeter je potrebna previdnost, ker imajo ti bolniki večjo možnost za krvavitve (glejte poglavje 4.4), pri bolnikih s cirozo (Child-Pugh A, B in C) pa niso izvedli formalnih študij za ugotavljanje odmerka.
The delay must be based on a benefit-risk assessment considering both the risk for thrombosis and the risk for bleeding in the context of the procedure and patient risk factors.
Odlog mora temeljiti na oceni koristi in tveganja, ki vključuje tako tveganje za trombozo kot tveganje za krvavitev, upoštevaje poseg in bolnikove dejavnike tveganja.
- Do not use this medicine if you notice any change in the appearance of the product.
- Zdravila ne uporabite, če opazite spremembo v njegovem videzu.
If you are not sure what to do, talk to your doctor or nurse immediately.
Če niste prepričani, kako to storite, se takoj obrnite na zdravnika ali medicinsko sestro.
In practice, if a confirmed significant decrease of the platelet count is observed (30 to 50 % of the initial value), enoxaparin sodium treatment must be immediately discontinued and the patient switched to another non-heparin anticoagulant alternative treatment.
Če se pojavi potrjeno občutno zmanjšanje števila trombocitov (30 do 50 % začetnega števila), je treba zdravljenje z natrijevim enoksaparinatom nemudoma prekiniti in bolnik mora preiti na drugo, neheparinsko antikoagulantno zdravljenje.
For continuous techniques, a similar delay of at least 12 hours should be observed before removing the catheter.
V primeru kontinuiranih tehnik je potreben podoben odlog vsaj 12 ur pred odstranitvijo katetra.
This helps your body to break them down and stops them from causing you harm.
Vašemu telesu pomaga razgraditi strdke, da vas ti
Change the place where you inject between the left and right sides of your stomach, depending on the area you were last injected.
Mesto injiciranja izmenjujte med levo in desno stranjo trebuha, odvisno od mesta, kjer ste zdravilo injicirali nazadnje.
Gently mix the contents of the bag.
Vsebino vrečke obzirno premešajte.
• Rare: Spinal haematoma* (or neuraxial haematoma).
• Redki: Spinalni hematom* (ali nevraksialni hematom).
Medicinal products that increase serum potassium levels may be administered concurrently with enoxaparin sodium under careful clinical and laboratory monitoring (see sections 4.4 and 4.8).
Zdravila, ki zvišujejo koncentracijo kalija v serumu, je mogoče uporabiti sočasno z natrijevim enoksaparinatom ob natančnem kliničnem in laboratorijskem nadzoru (glejte poglavji 4.4 in 4.8).
• Uncommon: Local irritation, skin necrosis at injection site
• Občasni: Lokalno draženje, nekroza kože na mestu injiciranja
The effect of this dose is usually sufficient for a 4-hour session; however, if fibrin rings are found, for example after a longer than normal session, a further dose of 50 IU to 100 IU/kg (0.5 to 1 mg/kg) may be given.
Učinek tega odmerka po navadi zadošča za 4-urno dializo, a če se pojavijo fibrinski obročki, npr. po dializi, ki je daljša kot po navadi, je mogoče dati dodaten odmerek od 50 do 100 i.e./kg (0,5 do 1 mg/kg).
In the in vitro purified system, enoxaparin sodium has a high anti-Xa activity (approximately 100 IU/mg) and low anti-IIa or anti thrombin activity (approximately 28 IU/mg), with a ratio of 3.6.
V prečiščenem sistemu in vitro ima natrijev enoksaparinat veliko aktivnost anti-Xa (približno 100 i.e./mg) in majhno aktivnost anti-IIa ali antitrombinsko aktivnost (približno 28 i.e./mg), z razmerjem 3,6.
When administered in conjunction with a thrombolytic (fibrin specific or non-fibrin specific), enoxaparin sodium should be given between 15 minutes before and 30 minutes after the start of fibrinolytic therapy.
Kadar je natrijev enoksaparinat uporabljen s trombolitikom (specifičnim ali nespecifičnim za fibrin), ga je treba dati v obdobju od 15 minut pred do 30 minut po začetku fibrinolitičnega zdravljenja.
These include ATIII-dependent inhibition of other coagulation factors like factor VIIa, induction of endogenous Tissue Factor Pathway Inhibitor (TFPI) release as well as a reduced release of von Willebrand factor (vWF) from the vascular endothelium into the blood circulation.
Mednje spada od ATIII odvisno zavrtje drugih koagulacijskih faktorjev, npr. faktorja VIIa, indukcija sproščanja endogenega zaviralca poti tkivnega faktorja (TFPI - Tissue Factor Pathway Inhibitor) in zmanjšano sproščanje von Willebrandovega faktorja (vWF) iz žilnega endotelija v krvni obtok.
Increases in aPTT and ACT are not linearly correlated with increasing enoxaparin sodium antithrombotic activity and therefore are unsuitable and unreliable for monitoring enoxaparin sodium activity.
Podaljšanje aPTČ in ACT ne korelirata linearno z večanjem antitrombotičnega delovanja natrijevega enoksaparinata, zato sta neprimerna in nezanesljiva za spremljanje njegovega delovanja.
STEMI type of heart attack if you are 75 years old or older:
Srčni infarkt vrste STEMI, če ste stari 75 let ali več:
• Ibuprofen, diclofenac, ketorolac or other medicines known as non-steroidal anti-inflammatory agents which are used to treat pain and swelling in arthritis and other conditions
• Ibuprofen, diklofenak, ketorolak ali druga zdravila, ki jih imenujemo nesteroidna protivnetna zdravila in se uporabljajo za zdravljenje bolečin in otekanja pri artritisu in drugih boleznih.
• Hypersensitivity to enoxaparin sodium, heparin or its derivatives, including other low molecular weight heparins (LMWH) or to any of the excipients listed in section 6.1;
• Preobčutljivostjo za natrijev enoksaparinat, heparin ali njegove derivate, vključno z nizkomolekularnimi heparini (NMH), ali katero koli pomožno snov, navedeno v poglavju 6.1.
The beneficial effect of enoxaparin sodium on the primary end point was consistent across key subgroups including age, gender, infarct location, history of diabetes, history of prior myocardial infarction, type of fibrinolytic administered, and time to treatment with study drug.
Ugodni učinek natrijevega enoksaparinata na primarni opazovani dogodek je bil konsistenten po vseh ključnih podskupinah, vključno s starostjo, spolom, mestom infarkta, anamnezo sladkorne bolezni, anamnezo predhodnega miokardnega infarkta, vrsto uporabljenega fibrinolitika in časom do zdravljenja z raziskovanim zdravilom.
• An initial dose of 3,000 IU (30 mg) of Thorinane will be given as injection into your vein.
• Začetni odmerek 3.000 i.e. (30 mg) zdravila Thorinane boste dobili kot injekcijo v veno.
In order to assure the accuracy of the small volume to be injected, it is recommended to dilute the drug to 300 IU/mL (3 mg/mL).
Da bi zagotovili točnost majhnih injiciranih količin, je zdravilo priporočljivo razredčiti na 300 i.e./ml (3 mg/ml).
STEMI type of heart attack if you are under 75 years old:
Srčni infarkt vrste STEMI, če ste mlajši od 75 let:
When the quantity of drug to be injected requires to be adjusted based on the patient's body weight, use the graduated pre-filled syringes to reach the required volume by discarding the excess before injection.
Če potrebna količina zdravila za injiciranje zahteva prilagoditev glede na bolnikovo telesno maso, uporabite graduirano napolnjeno injekcijsko brizgo, s katero boste potrebno količino dosegli tako, da boste pred injiciranjem zavrgli odvečno količino.
Enoxaparin sodium is a biological substance obtained by alkaline depolymerization of heparin benzyl ester derived from porcine intestinal mucosa.
Natrijev enoksparinat je biološka snov, dobljena z alkalno depolimerizacijo heparinovega benzilestra, pridobljenega iz črevesne sluznice svinj.
Oral anticoagulant therapy should be initiated when appropriate (see “Switch between enoxaparin sodium and oral anticoagulants” at the end of section 4.2).
Ko je ustrezno, je treba uvesti peroralne antikoagulanse (glejte "Prehod med natrijevim enoksaparinatom in peroralnimi antikoagulansi" na koncu poglavja 4.2).
The rates of venous thromboembolism at the end of the double-blind phase were 12.0 % (n=20) in the placebo group and 4.8% (n=8) in the enoxaparin sodium group; p=0.02.
Deleža venskih trombembolij na koncu dvojno slepe faze sta bila 12,0 % (n = 20) v skupini s placebom in 4,8 % (n = 8) v skupini z natrijevim enoksaparinatom, p = 0,02.
If a child accidentally injects or swallows Thorinane, take them to a hospital causualty department straight away.
Če si otrok po nesreči injicira ali zaužije zdravilo Thorinane, ga nemudoma peljite v bolnišnično ambulanto za nujno pomoč.
Animal studies have not shown any evidence of foetotoxicity or teratogenicity (see section 5.3).
Študije na živalih niso pokazale znakov fetotoksičnosti ali teratogenosti (glejte poglavje 5.3).
Enoxaparin sodium is contraindicated in patients with:
Natrijev enoksaparinat je kontraindiciran pri bolnikih s:
However, your doctor may give you a futher dose of 50 IU to 100 IU (0.5 to 1 mg) for every kilogram of your weight, if necessary.
Vendar vam zdravnik lahko da dodaten odmerek od 50 do 100 i.e. (0,5 do 1 mg) na kilogram telesne mase, če je to potrebno.
The oral absorption of enoxaparin sodium is unlikely.
Peroralna absorpcija natrijevega enoksaparinata ni verjetna.
The pharmacokinetic parameters of enoxaparin sodium have been studied primarily in terms of the time course of plasma anti-Xa activity and also by anti-IIa activity, at the recommended dosage ranges after single and repeated SC administration and after single IV administration.
Farmakokinetične parametre natrijevega enoksaparinata so raziskali predvsem, kar zadeva časovni potek plazemske aktivnosti anti-Xa, pa tudi aktivnosti anti-IIa, in sicer v priporočenih razponih odmerkov po enkratni in ponavljajoči se subkutani uporabi ter po enkratni intravenski uporabi.
INSTRUCTIONS FOR USE: PREFILLED SYRINGE
NAVODILA ZA UPORABO: NAPOLNJENA INJEKCIJSKA BRIZGA
Use of heparin is usually not recommended in patients with acute infective endocarditis due to the risk of cerebral haemorrhage.
Uporaba heparina pri bolnikih z akutnim infekcijskim endokarditisom po navadi ni priporočljiva zaradi tveganja za možgansko krvavitev.
CARTON (Packs of 2 or 10)
ŠKATLA (pakiranja po 2 ali 10)
- Check the syringe is not damaged and the medicine in it is a clear solution.
- Prepričajte se, da injekcijska brizga ni poškodovana in da je raztopina v njej bistra.
This study included patients with heart failure (NYHA Class III or IV); acute respiratory failure or complicated chronic respiratory insufficiency, and acute infection or acute rheumatic; if associated with at least one VTE risk factor (age ≥75 years, cancer, previous VTE, obesity, varicose veins, hormone therapy, and chronic heart or respiratory failure).
Študija je vključila bolnike s srčnim popuščanjem (razred III ali IV po NYHA), akutno dihalno odpovedjo ali zapleteno kronično respiratorno insuficienco oz. akutno okužbo ali akutno revmatično boleznijo, če so imeli vsaj en dejavnik tveganja za VTE (starost ≥ 75 let, rak, predhodna VTE, debelost, varikozne vene, hormonsko zdravljenje, kronično srčno popuščanje ali kronična dihalna odpoved).
All patients also received warfarin sodium (dose adjusted according to prothrombin time to achieve an INR of 2.0 to 3.0), commencing within 72 hours of initiation of enoxaparin sodium or standard heparin therapy, and continuing for 90 days.
Vsi bolniki so prejeli tudi natrijev varfarinat (odmerek prilagojen protrombinskemu času, tako da je bilo doseženo INR od 2,0 do 3,0), z začetkom v 72 urah po uvedbi natrijevega enoksaparinata ali običajnega heparinskega zdravljenja in z nadaljevanjem 90 dni.
• Prophylaxis of venous thromboembolic disease in moderate and high risk surgical patients, in particular those undergoing orthopaedic or general surgery including cancer surgery.
• Profilakso venske trombembolične bolezni pri kirurških bolnikih z zmernim ali velikim tveganjem, zlasti po ortopedskih ali splošnih operacijah, vključno z operacijami zaradi raka.
The risk of HIT is higher in postoperative patients and mainly after cardiac surgery and in patients with cancer.
Tveganje za HIT je večje pri bolnikih po operaciji in predvsem po operacijah na srcu ter pri onkoloških bolnikih.
• Switch between enoxaparin sodium and vitamin K antagonists (VKA) Clinical monitoring and laboratory tests [prothrombin time expressed as the International Normalized Ratio (INR)] must be intensified to monitor the effect of VKA.
• Prehod med natrijevim enoksaparinatom in antagonisti vitamina K (VKA - Vitamin K Antagonists) Za nadzor nad učinkom VKA je treba poostriti klinični nadzor in laboratorijske preiskave (protrombinski čas, izražen kot internacionalno normalizirano razmerje [INR]).
Limited data are available in patients with hepatic impairment (see sections 5.1 and 5.2) and caution should be used in these patients (see section 4.4).
Podatkov o bolnikih z okvaro jeter je malo (glejte poglavji 5.1 in 5.2), zato je pri takšnih bolnikih potrebna previdnost (glejte poglavje 4.4).
• Thorinane is usually given by injection underneath the skin (subcutaneous).
• Zdravilo Thorinane se po navadi injicira pod kožo (subkutano).
• Your doctor will decide how much Thorinane to give you.
• Zdravnik bo določil, koliko zdravila Thorinane boste dobili.
During haemodialysis, enoxaparin sodium should be introduced into the arterial line of the circuit at the beginning of the dialysis session.
Med hemodializo je treba natrijev enoksaparinat vbrizgati v arterijsko linijo sistema, in sicer na začetku dializiranja.
Required dose 30 IU/kg (0.3 mg/kg)
Potrebni odmerek: 30 i.e./kg (0,3 mg/kg)
The use of a tuberculin syringe or equivalent is recommended when using ampoules or multiple-dose vials to assure withdrawal of the appropriate volume of drug.
Pri uporabi ampul ali večodmernih vial je za odvzem ustrezne količine zdravila priporočljivo uporabiti tuberkulinsko ali drugo enakovredno brizgo.
• Treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), excluding PE likely to require thrombolytic therapy or surgery.
• Zdravljenje globoke venske tromboze (GVT) in pljučne embolije (PE), razen PE, ki bo verjetno zahtevala trombolitično zdravljenje ali operacijo.
Enoxaparin sodium is not recommended for patients with end stage renal disease (creatinine clearance <15 mL/min) due to lack of data in this population outside the prevention of thrombus formation in extra corporeal circulation during haemodialysis.
Natrijev enoksaparinat ni priporočljiv za bolnike s končno odpovedjo ledvic (očistek kreatinina < 15 ml/min), ker za to populacijo ni dovolj podatkov o drugih uporabah razen za preprečevanje nastanka krvnih strdkov pri zunajtelesnem obtoku med hemodializo.
Pregnant women with mechanical prosthetic heart valves may be at higher risk for thromboembolism.
Nosečnice z mehaničnimi protetičnimi srčnimi zaklopkami imajo lahko večje tveganje za trombembolijo.
The drug substance is the sodium salt.
Zdravilna učinkovina je natrijeva sol.
Do not use Thorinane
Ne uporabljajte zdravila Thorinane
Enoxaparin sodium is to be used with extreme caution in patients with a history (>100 days) of heparininduced thrombocytopenia without circulating antibodies.
Natrijev enoksaparinat je treba skrajno previdno uporabljati pri bolnikih z anamnezo (> 100 dni) heparinsko izzvane trombocitopenije brez protiteles v obtoku.
There were no differences in the rates of bleeding or other complications during the double-blind or follow-up periods.
Med dvojno slepim obdobjem študije in med obdobjem spremljanja ni bilo razlik v deležih krvavitev ali drugih zapletov.
2) Sit or lie in a comfortable position so you are relaxed.
2) Udobno sedite ali lezite tako, da boste v sproščenem položaju in da boste zlahka videli tisti del trebuha, v katerega boste injicirali zdravilo.
It is important to achieve haemostasis at the puncture site after PCI.
Po PKI je pomembno doseči hemostazo na mestu punkcije.
The risk of these events is higher with the use of post-operative indwelling epidural catheters, with the concomitant use of additional drugs affecting haemostasis such as Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), with traumatic or repeated epidural or spinal puncture, or in patients with a history of spinal surgery or spinal deformity.
Tveganje za te učinke je večje v primeru pooperacijske uporabe stalnih epiduralnih katetrov, med sočasno uporabo dodatnih zdravil, ki vplivajo na hemostazo, npr. nesteroidnih protivnetnih zdravil (NSAID), v primeru travmatske ali ponavljajoče se epiduralne ali spinalne punkcije, ali pri bolnikih z anamnezo spinalne operacije ali spinalno deformacijo.
If you stop, you could get a blood clot which can be very dangerous.
Če zdravilo prenehate uporabljati, se vam lahko pojavi krvni strdek, to pa je lahko zelo nevarno.
Dosage table for patients with severe renal impairment (creatinine clearance [15-30] mL/min):
Preglednica za odmerjanje pri bolnikih s hudo okvaro ledvic (očistek kreatinina 15-30 ml/min):
• Obese Patients
• Debeli bolniki
For patients currently receiving a DOAC, the first dose of enoxaparin sodium should be given at the time the next DOAC dose would be taken.
Bolnikom, ki trenutno prejemajo DOAC, je treba dati prvi odmerek natrijevega enoksaparinata ob času, ko bi bil na vrsti naslednji odmerek DOAC.
Close the container lid tightly and place the container out of reach of children.
Pokrov zabojnika trdno privijte in ga shranite nedosegljivo otrokom.
Acetylsalicylic acid is recommended for all patients without contraindications at an initial oral loading dose of 150-300 mg (in acetylsalicylic acid-naive patients) and a maintenance dose of 75-325 mg/day long-term regardless of treatment strategy.
Acetilsalicilna kislina je priporočljiva za vse bolnike brez kontraindikacij, in sicer v začetnem peroralnem polnilnem odmerku od 150 do 300 mg (pri bolnikih, ki še niso prejemali acetilsalicilne kisline) in v vzdrževalnem odmerku od 75 do 325 mg/dan dolgoročno, ne glede na strategijo zdravljenja.
If you use more Thorinane than you should
Če ste uporabili večji odmerek zdravila Thorinane, kot bi smeli:
Other medicines and Thorinane Tell your doctor, pharmacist or nurse if you are taking, have recently taken or might take any other medicines.
Druga zdravila in zdravilo Thorinane Obvestite svojega zdravnika ali farmacevta, če uporabljate ali pa boste morda začeli uporabljati katero koli drugo zdravilo.
The whole length of the needle should be introduced vertically into a skin fold gently held between the thumb and index finger.
Celotno dolžino igle navpično zabodite v kožno gubo, ki jo nežno držite med palcem in kazalcem.
Patients received enoxaparin sodium (4,000 IU (40 mg) SC) daily for 6 to 10 days and were then randomly assigned to receive either enoxaparin sodium or placebo for another 21 days.
Bolniki so prejemali natrijev enoksaparinat (4.000 i.e. (40 mg) subkutano) na dan od 6 do 10 dni, potem pa so bili randomizirani na prejemanje natrijevega enoksaparinata ali placeba za nadaljnjih 21 dni.
CARTON OF (Packs of 2 or 10)
ŠKATLA PO (pakiranja po 2 ali 10)
If you forget to use Thorinane
Če ste pozabili uporabiti zdravilo Thorinane
• Extended prophylaxis of DVT following cancer surgery A double-blind, multicenter trial, compared a four-week and a one-week regimen of enoxaparin sodium prophylaxis in terms of safety and efficacy in 332 patients undergoing elective surgery for abdominal or pelvic cancer.
• Podaljšana profilaksa GVT po onkoloških operacijah Dvojno slepo multicentrično preskušanje je primerjalo štiritedensko in enotedensko shemo profilakse z natrijevim enoksaparinatom glede varnosti in učinkovitosti pri 332 bolnikih, ki so imeli opravljeno elektivno operacijo zaradi raka v trebuhu ali medeničnem predelu.
Treatment in patients with unstable angina and non-Q-wave MI
Zdravljenje bolnikov z nestabilno angino pektoris in MI brez zobca Q
Treatment in patients with DVT with or without PE
Zdravljenje bolnikov z GVT s PE ali brez nje
Careful clinical monitoring is advised and dose reduction might be considered in patients older than 75 years treated for STEMI (see sections 4.2 and 5.2).
Priporočljiv je skrben klinični nadzor in pri bolnikih, starejših od 75 let, zdravljenih zaradi STEMI, pride v poštev zmanjšanje odmerka (glejte poglavji 4.2 in 5.2).
The risk of antibody-mediated HIT also exists with LMWHs.
Tudi pri NMH obstaja tveganje za HIT, posredovano s protitelesi.
If there are clinical symptoms suggestive of HIT (any new episode of arterial and/or venous thromboembolism, any painful skin lesion at the injection site, any allergic or anaphylactoid reactions on treatment), platelet count should be measured.
V primeru kliničnih simptomov, ki nakazujejo HIT (kakršen koli nov pojav arterijske in/ali venske trombembolije, kakršna koli boleča kožna sprememba na mestu injiciranja, kakršna koli alergijska ali anafilaktoidna reakcija na zdravljenje), je treba kontrolirati število trombocitov.
• Active clinically significant bleeding and conditions with a high risk of haemorrhage, including recent haemorrhagic stroke, gastrointestinal ulcer, presence of malignant neoplasm at high risk of bleeding, recent brain, spinal or ophthalmic surgery, known or suspected oesophageal varices, arteriovenous malformations, vascular aneurysms or major intraspinal or intracerebral vascular abnormalities;
• Aktivno, klinično pomembno krvavitvijo in stanji, povezanimi z velikim tveganjem za krvavitev, vključno z nedavno hemoragično možgansko kapjo, gastrointestinalno razjedo, prisotnostjo maligne novotvorbe z velikim tveganjem za krvavitev, nedavno operacijo na možganih, hrbtnem mozgu ali očeh, znanimi varicami požiralnika ali sumom nanje, arteriovenskimi malformacijami, žilnimi anevrizmami ali pomembnimi intraspinalnimi ali intracerebralnimi žilnimi nepravilnostmi.