Spinal Subarachnoid Hemorrhage due to a Thoracic Neurinoma during Anticoagulation Therapy —A Case Report—

Motomochi, M; Makita, Yasumasa; Nabeshima, S; Itagaki, Tetsuya; T, Tei

doi:10.2176/nmc.21.781

Cited by 13 publications

(3 citation statements)

References 13 publications

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“…Our primary literature search yielded 4136 articles, of which 809 abstracts were selected for review. Of those, 223 full‐length articles were screened and data were extracted from 57 studies that fulfilled our inclusion and exclusion criteria [3–59]. The secondary search strategy identified an additional 80 abstracts and eventually data were extracted from six additional studies [60–65].…”

Section: Resultsmentioning

confidence: 99%

Management of anticoagulation following central nervous system hemorrhage in patients with high thromboembolic risk

Hawryluk

Austin

Furlan

et al. 2010

Journal of Thrombosis and Haemostasis

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To cite this article: Hawryluk GWJ, Austin JW, Furlan JC, Lee JB, OÕKelly C, Fehlings MG. Management of anticoagulation following central nervous system hemorrhage in patients with high thromboembolic risk. J Thromb Haemost 2010; 8: 1500-8. Summary. Background:Patients who present with central nervous system (CNS) hemorrhage while on anticoagulation (AC) for thromboembolic (TE) risk factors are a challenge to manage. Objective: We sought to inform decisions surrounding the timing and intensity of AC resumption by performing a systematic review. Methods: Three reviewers screened publications from Medline and EMBASE and extracted data. Hemorrhagic and TE adverse events that occurred subsequent to the index hemorrhage were recorded, as was their timing relative to presentation and covariates that might influence their occurrence. Results: Data were extracted from 63 publications detailing 492 patients; 7.7% of patients experienced hemorrhagic complications and 6.1% experienced TE complications. Hemorrhagic complications were more common within 72 h of presentation while TE complications were more common thereafter. Patients restarted on AC after 72 h were significantly more likely to have a TE complication (P = 0.006) and those restarted before 72 h were more likely to hemorrhage (P = 0.0727). Factors associated with rehemorrhage included younger age, traumatic cause, subdural hematomas and failure to reverse AC. TE complications were more common in younger patients and those with spinal hemorrhage, multiple hemorrhages, and non-traumatic causes of the index hemorrhage. Re-initiation of AC at a lower intensity also significantly increased the risk of TE complications. Interpretation: Our results suggest that it may be prudent to re-initiate AC earlier than previously thought, with the timing and intensity modified based on predictors of TE and hemorrhagic complications. These findings must be explored in a prospective study because of limitations inherent to the analyzed studies.

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Section: Resultsmentioning

confidence: 99%

Management of anticoagulation following central nervous system hemorrhage in patients with high thromboembolic risk

Hawryluk

Austin

Furlan

et al. 2010

Journal of Thrombosis and Haemostasis

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“…[4][5][6][7] Similarly few reports have described hemorrhagic conversion of spinal schwannomas presenting with spinal hematomas and related symptoms. [8][9][10][11][12][13][14][15][16] These reports have described hemorrhage from spinal schwanno- Table 1 and Figure 2 show a distribution in the spine of spinal schwannomas presenting with intradural subdural/ intratumoral hemorrhage, with most frequent presentation in the thoracic spine. Several reports have postulated changes in vascular supply as contributing factors to hemorrhage development in the setting of spinal schwannomas.…”

Section: Discussionmentioning

confidence: 99%

“…15,16 Motomochi et al reported a case of a patient on warfarin anticoagulation presenting with pain, numbness, lower extremity weakness, and urinary symptoms and was found to have a T10 lesion interaoperatively consistent with a nerve sheath tumor. 15 Ichinose et al also described hemorrhage within a spinal intradural schwannoma at the conus medullaris (thoraco-lumbar junction) presenting with paraparesis and urinary incontinence in a patient receiving anticoagulation, although the precise type of anticoagulant therapy is not described. 16 No reports specifically describe an association with antiplatelet therapy.…”

Section: Discussionmentioning

confidence: 99%

Hemorrhagic thoracic schwannoma presenting with intradural hematoma and acute paraplegia after spinal manipulation therapy

et al. 2016

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Hemorrhagic conversion of spinal schwannomas represents a rare occurrence; also rare is the development of a spinal intradural hematoma after spinal manipulation therapy. We report a unique presentation of paraplegia in a patient who underwent spinal manipulation therapy and was found to have a hemorrhagic thoracic schwannoma at time of surgery in the setting of anti-platelet therapy use. In patients with spinal schwannomas, tumor hemorrhage is a rare occasion, which can be considered in the setting of additive effects of spinal manipulation therapy and antiplatelet therapy.keywords: thoracic schwannoma, hemorrhagic schwannoma, spinal schwannoma, intradural spinal hemorrhage volume 10 article 42

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Massive hemorrhage into intracranial neurinomas

Goetting

Swanson

1987

Surgical Neurology

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Massive bleeding into an intracranial neurinoma is a rare event. The 12th case of this particular occurrence, which was precipitated by weight lifting, is described and a review of the literature is presented. Risk factors for bleeding appear to be tumor size and vascularity. Presenting symptomatology is abrupt and includes headache, nausea, vomiting, and depressed consciousness. Preexisting symptoms referrable to and marked dysfunction of the cranial nerve of origin are present. Deficits of neighboring cranial nerves are frequent. Computed tomography demonstrates the hemorrhages and the tumors. Mild head injury and physical exertion were precipitating factors in two cases. One-fourth of the patients died, while the others made good recoveries.

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Spinal Subarachnoid Hemorrhage due to a Thoracic Neurinoma during Anticoagulation Therapy —A Case Report—

Abstract: SummaryA case of spinal subarachnoid hemorrhage due to a thoracic neurinoma during anti coagulation therapy is presented. The underlying pathology, clinical course and pertinent literature are reviewed.

Cited by 13 publications

References 13 publications

Management of anticoagulation following central nervous system hemorrhage in patients with high thromboembolic risk

Management of anticoagulation following central nervous system hemorrhage in patients with high thromboembolic risk

Hemorrhagic thoracic schwannoma presenting with intradural hematoma and acute paraplegia after spinal manipulation therapy

Massive hemorrhage into intracranial neurinomas

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