J Korean Soc Spine Surg.  2008 Jun;15(2):111-114. 10.4184/jkss.2008.15.2.111.

Spontaneous Spinal Epidural Hematoma after use of Anticoagulation Therapy

• Lee YS
• Kim WS
• Choi JC
• Na HY
• Shin MH

• KMID: 2097841
• DOI: http://doi.org/10.4184/jkss.2008.15.2.111

Abstract

Spontaneous epidural hematoma (SEH) is an uncommon cause of spinal cord compression. It tends to occur in patients at high risk for hemorrhage. Various medications are associated with SEH, including antiplatelet agents, anticoagulants, and thrombolytics. Because patients usually present with neurologic deficits, early diagnosis and proper management are required to achieve full recovery. The principal management is surgical evacuation of the SEH via laminectomy. We present a case of a 51-year-old woman on both oral aspirin and intravenous heparin who subsequently developed a SEH.

Keyword

Spinal cord compression; Epidural hematoma; Anticoagulants; Hematoma; Laminectomy

MeSH Terms

Anticoagulants
Aspirin
Early Diagnosis
Female
Hematoma
Hematoma, Epidural, Spinal
Hemorrhage
Heparin
Humans
Laminectomy
Middle Aged
Neurologic Manifestations
Platelet Aggregation Inhibitors
Spinal Cord Compression
Anticoagulants
Aspirin
Heparin
Platelet Aggregation Inhibitors

Figure

• 

  Fig. 1. (A) T1-weighted sagittal and axial image of the thoracolumbar spine shows a posterior epidural intermediate signal intensity at T12-L5 level. (B) T2-weighted sagittal and axial image of the thoracolumbar spine shows the high signal intensity suggesting hematoma.

• 

  Fig. 2. (A) Intraoperative field image of thoracolumbar spine shows that fill with hematoma (arrow) in epidural space. (B) Intraoperative field image of thoracolumbar spine after evacuation of hematoma.

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