Objective The present study is a case report of a 57-year-old female with controlled hypertension who presented with spontaneous spinal epidural hematoma (SSEH) mimicking a cerebrovascular accident (CVA) and was successfully treated by surgical decompression. Methods A 57-year-old woman with a medical history of hypertension presented with a sudden onset of weakness in the right upper and lower extremities. Weakness of grade 3/5 was noted in her right upper and lower extremities, but there was no motor weakness of the right facial muscles. A magnetic resonance imaging (MRI) exam of the cervical spine revealed an epidural hematoma extending from level C5 to level C7, causing spinal cord compression. Results During surgery, a cervical spinal epidural hematoma (SEH) was evacuated. Postoperatively, the power in both limbs improved to grade 5/5 just after surgery. Conclusions A high degree of suspicion, meticulous history taking, and physical examination have a great importance in these rare conditions because anticoagulant therapy as a routine treatment for ischemic CVA could be life-threatening. Palavras-chave► hematoma epidural espinhal espontâneo ► coluna cervical ResumoObjetivo O presente estudo se trata de um relato de caso de uma paciente de 57 anos, com hipertensão controlada, que apresentou um hematoma epidural espinhal espontâneo (HEEE) imitando um acidente vascular cerebral (AVC), e que foi tratada com sucesso através de descompressão cirúrgica. Métodos Uma mulher de 57 anos com um histórico de hipertensão apresentou um súbito princípio de fraqueza nas extremidades superior e inferior do lado direito. Foi notada força muscular de grau 3/5 em suas extremidades superior e inferior do lado direito, mas não houve fraqueza motora dos músculos faciais no lado direito. Um exame de ressonância magnética (RM) da coluna cervical revelou um hematoma epidural estendendo-se do nível C5 ao nível C7, causando uma compressão medular.

Background: Methadone maintenance therapy (MMT) is one of the most common treatments for drug use complications. Sexual disorders are reported as common side effects of these treatments, the most important of which is erectile dysfunction. Objectives: The present study aimed to evaluate the effects of dose-dependence and duration of methadone treatment on erectile dysfunction in patients undergoing methadone maintenance therapy. Methods: This cross-sectional study was performed on 192 opioid-dependent men undergoing methadone maintenance treatment at Shariati Hospital in Fasa (Iran) in 2018. Samples were randomly selected by the available sampling method. Each individual was given a demographic questionnaire, methadone consumption questionnaire, and standard erectile dysfunction questionnaire. Results: Mean age of patients was 41.41 ± 8.41, the mean duration of MMT was 60.53 ± 37.8 months, and the mean therapeutic dose was 83.68 ± 27.07mg. 171 (86.8%) were married, 13 (6.8%) had no erectile dysfunction. While 37 (19.3%) had mild, 78 (19.3%) mild to moderate, 48 (25%) moderate, and 16 (8.3%) had severe erectile dysfunction. The results showed that erectile dysfunction was significantly associated with age and duration of consumption. However, the type of methadone and marital status had no significant association with erectile function. Conclusions: Erectile dysfunction is common in men receiving MMT. The severity of erectile dysfunction is related to the duration of MMT and is not dose-dependent. Therefore, subjects who are on long-term MMT need more frequent erectile dysfunction assessment.