Multilevel Acute Spinal Epidural Hematoma in a Patient With Chronic Renal Failure-Case Report-

Ziyal, Ibrahim M.; Aydın, Serdar Onur; İnci, Servet; Şahin, Altan; Özgen, Tunçalp

doi:10.2176/nmc.43.409

Cited by 15 publications

(16 citation statements)

References 25 publications

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“…Conservative treatment has also been documented, and it was employed only when neurological deficits improved in the early phase or with the coexistence of coagulopathy 15) . Multilevel acute epidural hematomas may be difficult to treat operatively in patients with coagulopathy 16) . Although the functional recovery of these patients may not be complete, the SSEH can be treated without surgery, and the patient should be protected from the significant risk of surgical intervention 15) .…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Spinal Epidural Hematoma

Baek

Hur

Kwon

et al. 2008

J Korean Neurosurg Soc

118

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Section: Discussionmentioning

confidence: 99%

Spontaneous Spinal Epidural Hematoma

Baek

Hur

Kwon

et al. 2008

J Korean Neurosurg Soc

118

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“…In such patients aPTT, INR, thrombocyte count, and bleeding-clotting time should be necessarily checked. 16 Our patient had an aPTT of 61.2 seconds, a PT of 42 seconds, and an INR of 3.54, all of which were higher than normal levels. Anatomically, spinal epidural hematomas oiriginate from epidural venous plexus or small arteries located between two the layers of dura mater.…”

Section: Case Reportmentioning

confidence: 50%

Spontaneous Cervi̇cal Epi̇dural Hematoma Due to Oral Anti̇coagulant Use

Altınbilek¹,

Öztürk²,

Çaltılı³

et al. 2014

J Pharm Sci Innov

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Spontaneous spinal epidural hematoma (SCEH) is a considerbaly rare clinical condition. It may lead to persistent neurological deficits or even death unless recognized and treated early in its course. It usually occurs after trauma but may also develop spontaneously. Majority of cases can be diagnosed with a detailed neurological examination and magnetic resonance imaging (MRI). Urgent surgical tehrapy is the preferred mode of treatment in advanced cases while a conservative approach is selected for cases with mild neurological deficit. MRI is regarded as the imaging modality of choice fort he diagnosis of SCEH. We report a case of nontrumatic SCEH after oral anticoagulant (OAC) use that presented with sudden-onset paraplegia. We also reviewed the relevant literature. Keywords: Spinal epidural hematoma, nontraumatic, oral anticoagulant, MRI, human prothrombin complex concentrate INTRODUCTİONSpontaneous spinal epidural hematoma (SCEH) is a rare condition and it is the rarest cause of neck pain. However, it is a medical emergency since it may lead to permenant neuroogical deficit or even death if missed or left untreated. The clinical picture usually starts with pain corresponding to the level of bleeding and progresses into neurological deficits. Depending on the site of occurrence, it may cause paraparesia, quadriparesia, and sphincteric malfunction. 1Usually observed in cervical and thoracic regions, SCEHs are the rarest among the pathologies causing spinal cord compression.2-5 Epidural hematomas are generally located to the posterior aspect of the spinal cord owing to close relationship of the dura with the posterior longitudinal ligament at the anterior aspect of the dural sac. 2,3,5,6 Epidural hematomas located in the cervical region manifest with acute or chronic symptoms, although neck pain or root pain are the most common complaints. Motor and/or sensory deficits accompany the clinical picture depending on the magnitude of spinal cord compression.2,7,8 SCEH follows a trauma most of the time, although spontaneous SCEHs have also rarely been described. SCEH may complicate hypertension, vascular malformations, bleeding disorders, anticoagulant therapy, tumors, pregnancy, vasculitic syndromes, surgical interventions, and epidural anesthesia. [3][4][5][6]9,10 In this case, we aimed to presented a SCEH case. There was no ethical problem in this case. Case reportA 26-year-old man presented with sudeen-onset neck pain and wekaness in arms and legs. He had been on oral antioagulant therapy (warfarin sodium 5 mg for 30 days). His genreal status was moderately impaired and he was consicous, cooperated and oriented. On physical examination the cardiac sounds were normal, abdomen was nontender, pupils were isocoric, and cranial nerves were roughly intact. Motor examination revealed a muscle strength of 1/5 in left wrist flexion and extension and 1/5 in right wrist flexion and extension. Sensory examination showed anesthesia on T1 dermatome and its continuity. TCR was bilaterally negative. His vital sgins were a...

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“…Literature shows that conservative treatment is also employed but only when neurological deficits improve in the early phase or with the coexistence of a coagulopathy (Tailor et al, 2006). Multilevel traumatic SEH may be difficult to treat operatively in patients with coagulopathy (Ziyal et al, 2003) and these patients should be therefore protected from significant risk of a surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Traumatic spinal epidural hematoma: A case review

Prusty¹

2017

Int Res J Med Med Sci

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There are very few cases of post traumatic Spinal Epidural Hematoma (SEH) reported in literature. The authors have reported five such cases of SEH who have all had a history of trauma. All five cases underwent early surgical intervention and four of them recovered completely while one recovered with some post-operative neurological deficit. SEH must be considered when there is a history of trauma to spine to avoid unnecessary delay in initiating appropriate treatment.

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Multilevel Acute Spinal Epidural Hematoma in a Patient With Chronic Renal Failure-Case Report-

Cited by 15 publications

References 25 publications

Spontaneous Spinal Epidural Hematoma

Spontaneous Spinal Epidural Hematoma

Spontaneous Cervi̇cal Epi̇dural Hematoma Due to Oral Anti̇coagulant Use

Traumatic spinal epidural hematoma: A case review

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