A case of spontaneous spinal epidural haematoma in the emergency department associated with warfarin therapy

Yardan T., Baydin A., Genc S., Çokluk C., Acar E., Aydin K.

HONG KONG JOURNAL OF EMERGENCY MEDICINE, cilt.17, sa.4, ss.367-371, 2010 (SCI-Expanded) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 17 Sayı: 4
  • Basım Tarihi: 2010
  • Doi Numarası: 10.1177/102490791001700410
  • Dergi Adı: HONG KONG JOURNAL OF EMERGENCY MEDICINE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.367-371
  • Anahtar Kelimeler: Anticoagulants, hemorrhage, spinal cord compression, spinal epidural hematoma, warfarin, ORAL ANTICOAGULANT-THERAPY, HEMORRHAGE SECONDARY, COMPLICATION
  • Ondokuz Mayıs Üniversitesi Adresli: Evet

Özet

Spontaneous spinal epidural haematoma (SSEH) is a neurosurgical emergency that requires early diagnosis and treatment. An 88-year-old man presented to the emergency department with complaints of weakness in the legs, walking deficit, incontinence and back pain for the last two days. He had been on warfarin therapy for 5 years for atrial fibrillation. There was no antecedent trauma. The neurological examination revealed hypoesthesia below the T6 level, anaesthesia below the T10 level and complete paraplegia of both lower extremities. The INR level was 7.81 on admission. Magnetic resonance imaging revealed a posterolateral epidural haematoma extending from T2 to L5. He was given fresh frozen plasma and vitamin K in the emergency department. Emergency thoracic and lumbar laminectomy was performed by neurosurgeons. The probability of SSEH should be investigated in any patient under anticoagulation therapy who presents with signs of spinal compression in the emergency department. (Hong Kong j.emerg.med. 2010;17:367-371)