Spinal epidural hematoma in a patient on anticoagulation treatment with warfarin. A case report
Keywords:
hematoma, epidural, spinal, spontaneous, WarfarinAbstract
Introduction: spontaneous epidural hematoma is a rare condition that may be accompanied by spinal cord compression. It can be caused by several factors, one of which is poor control of oral anticoagulants.Patient information: 57-year-old female patient, with a history of mitral valve insufficiency, with anticoagulant treatment with warfarin, who was taken to the Emergency Room of the “Arnaldo Milián Castro” Hospital due to numbness in both lower limbs; physical examination revealed asymmetric paraparesis, exalted osteotendinous aquilean and patellar reflexes (+2), left Babinsky reflex and dorsal sensory level 6-7.
Conclusions: spinal epidural hematoma is a disease causing acute spinal cord compression that requires immediate diagnosis and urgent surgical treatment.
Downloads
References
1. Chuliá Carrasco V, Gómez Barbero P. Hematoma espinal epidural espontáneo asociado a tratamiento anticoagulante con acenocumarol: a propósito de un caso. Rev Asoc Argent Ortop Traumatol [Internet]. 2019 [citado 15/11/2020];84(3):260-264. Disponible en: http://www.scielo.org.ar/pdf/raaot/v84n3/v84n3a09.pdf. https://doi.org/10.15417/issn.1852-7434.2019.84.3.892
2. Goldfine C, Glazer C, Ratzan RM. Spontaneous Spinal Epidural Hematoma from Rivaroxaban. Clin Pract Cases Emerg Med [Internet]. 2018 [citado 15/11/2020];2(2):151-154. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5965116/. https://dx.doi.org/10.5811/cpcem.2018.2.37096
3. Castanheira Gomes AP, Cernadas E, Sá J, Brito H, Costa R. Spontaneous Spinal Haemorrhage as a Complication of Oral Anticoagulant Therapy: A Case Report and Literature Review. EJCRIM [Internet]. 2018 [citado 15/11/2020];5(12):[aprox. 4 p.]. Disponible en: https://www.ejcrim.com/index.php/EJCRIM/article/view/887/1580. https://doi.org/10.12890/2018_000887
4. Tawk C, El Hajj Moussa M, Zgheib R, Nohra G. Spontaneous epidural hematoma of the spine associated with oral anticoagulants: 3 Case Studies. Int J Surg Case Rep [Internet]. 2015 [citado 15/11/2020];13:8-11. Disponible en: https://www.sciencedirect.com/science/article/pii/S2210261215002436. https://doi.org/10.1016/j.ijscr.2015.05.022
5. Babayev R, Ekşi MŞ. Spontaneous thoracic epidural hematoma: a case report and literature review. Childs Nerv Syst [Internet]. 2016 [citado 15/11/2020];32:181–187. Disponible en: https://link.springer.com/article/10.1007/s00381-015-2768-5. https://doi.org/10.1007/s00381-015-2768-5
6. Aycan A, Ozdemir S, Arslan H, Gonullu E, Bozkına C. Idiopathic Thoracic Spontaneous Spinal Epidural Hematoma. Case Rep Surg [Internet]. 2016 [citado 15/11/2020];2016:5430708. Disponible en: https://www.hindawi.com/journals/cris/2016/5430708/. https://doi.org/10.1155/2016/5430708
7. Ozel O, Demircay E, Kircelli A, Cansever T. Atypical Presentation of an Epidural Hematoma in a Patient Receiving Rivaroxaban After Total Hip Arthroplasty. Ortopedics [Internet]. 2016 [citado 15/11/2020];39(3):e558-e560. Disponible en: https://journals.healio.com/doi/10.3928/01477447-20160414-01. https://doi.org/10.3928/01477447-20160414-01
8. Ismail R, Zaghrini E, Hitti E. Spontaneous Spinal Epidural Hematoma in a Patient on Rivaroxaban: Case Report and Literature Review. J Emerg Med [Internet]. 2017 [citado 15/11/2020];53(4):536-539. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0736467917304870. https://doi.org/10.1016/j.jemermed.2017.06.005
9. Castillo JM, Afanador HF, Manjarrez E, Morales XA. Non-traumatic spontaneous spinal subdural hematoma in a patient with non-valvular atrial fibrillation during treatment with rivaroxaban. Am J Case Rep [Internet]. 2015 [citado 15/11/2020];16:377-81. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4479261/. https://doi.org/10.12659/AJCR.893320
10. Yu JX, Liu J, He C, Sun LY, Xiang SS, Ma YJ, et al. Spontaneous Spinal Epidural Hematoma: A Study of 55 Cases Focused on the Etiology and Treatment Strategy. World Neurosurg [Internet]. 2017 [citado 15/11/2020];98:546-554. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S1878875016312256. https://doi.org/10.1016/j.wneu.2016.11.077
11. Muñoz González A, Cuello JP, Rodríguez Cruz PM, Iglesias Mohedano AM, Domínguez Rubio R, Romero Delgado F, et al. Hematoma espinal epidural espontáneo: estudio retrospectivo de una serie de 13 casos. Neurol [Internet]. 2015 [citado 15/11/2020];30(7):393-400. Disponible en: https://www.sciencedirect.com/science/article/pii/S0213485314000590. https://doi.org/10.1016/j.nrl.2014.03.007
12. El Alayli A, Neelakandan L, Krayem H. Spontaneous Spinal Epidural Hematoma in a Patient on Apixaban for Nonvalvular Atrial Fibrillation. Case Rep Hematol [Internet]. 2020 [citado 15/11/2020];2020:7419050. Disponible en: https://www.hindawi.com/journals/crihem/2020/7419050/. https://doi.org/10.1155/2020/7419050
13. Bamps S, Decramer T, Vandenbussche N, Verhamme P, Thijs V, Van Loon J. Dabigatran-Associated Spontaneous Acute Cervical Epidural Hematoma. World Neurosurg [Internet]. 2015 [citado 15/11/2020];83(2):257-258. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S1878875014010067. https://doi.org/10.1016/j.wneu.2014.10.012
Downloads
Published
How to Cite
Issue
Section
License
Authors who have publications with this journal agree to the following terms:
- Authors will retain their copyright and assign to the journal the right of first publication of their work, which will simultaneously be subject to a Creative Commons License / Attribution-Noncommercial 4.0 International (CC BY-NC 4.0) that allows third parties to share the work as long as its author and first publication in this journal are indicated.
- Authors may adopt other non-exclusive license agreements for distribution of the published version of the work (e.g., depositing it in an institutional repository or publishing it in a monographic volume) as long as the initial publication in this journal is indicated.
- Authors are allowed and encouraged to disseminate their work through the Internet (e.g., in institutional telematic archives or on their web page) before and during the submission process, which can produce interesting exchanges and increase citations of the published work. (See The effect of open access).