Background Acupuncture therapy is well known. But there is no report that acupuncture in patients with coagulation dysfunction in stroke may lead to severe soft tissue injury. we report a case of acupuncture leading to severe soft tissue injury.Methods A 63-year-old female patient was hospitalized for stroke rehabilitation. After 2 years of discharge, severe subcutaneous hematoma caused by acupuncture was readmitted to hospital. She received medication and physical rehabilitation. we monitored

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... he international standardized ratio (INR) in plasma and observed the degree of dissipation of subcutaneous hematoma. the changes of patients during treatment were explored by data analysis.Findings Subcutaneous hematoma (area 20×20 cm) disappeared completely after 3 weeks of physical factor therapy. Small range (area ≤3×3 cm) subcutaneous hematoma can heal itself within 2 weeks. Improper acupuncture is only one of the causes of soft tissue injury. Stroke with coagulation dysfunction is not a contraindication of acupuncture treatment.Interpretation Our report suggests that previously unanticipated acupuncture treatment for stroke patients with coagulation dysfunction may lead to severe multiple soft tissue injuries. Although coagulation dysfunction is not a contraindication of acupuncture treatment, acupuncture treatment for stroke patients with coagulation dysfunction should be vigilant, strengthen the level of acupuncture operation, and fundamentally eliminate the problem. These cases are validation and supplement of adverse clinical reactions caused by improper acupuncture.