Multiple Spinal Chronic Subdural Hematomas Associated with Thoracic Hematomyelia: A Case Report and Literature Review

Oichi, Yuki; Toda, Hiroki; Yamagishi, Koji; Tsujimoto, Yoshitaka

doi:10.1016/j.wneu.2019.07.209

Cited by 4 publications

(7 citation statements)

References 48 publications

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“…Alternatively, mechanical alterations due to bleeding may induce a mass effect with acute CSF obstruction, which can also contribute to stretching of the meninges, dorsal nerve roots, or both, leading to discomfort or pain [ 19 ]. Finally, spinal subdural haematomas can cause neurological signs and pain secondary to meningeal irritation and compression of the cord or nerve roots [ 11 – 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Among the diagnostic imaging modalities available in veterinary medicine, MRI is the most reliable imaging modality for detecting spinal haemorrage and also holds the potential of determining the source of bleeding as it is the best way to pinpoint associated spinal lesions [ 1 – 3 , 11 , 23 , 24 ]. Acute haemorrhage is characterized by the presence of deoxyhemoglobin, depicted on high field MRI as discrete areas of hypointensity in T2-weighted and gradient echo T2 ∗ sequences and isointensity on T1W [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Treatment may include surgical removal of the haematoma, but this is dependent the localisation and extent of the lesion [ 3 , 11 , 12 ]. In the current case, surgery was not considered as the haemorrhagic lesions were intraparenchymal and affected most of the spinal cord segments.…”

Section: Discussionmentioning

confidence: 99%

“…The conservative option is based on discontinuing warfarin treatment and restoring coagulation using human prothrombin complex concentrate [ 35 ] (proven to be safe and effective in patients with intracranial haematomas) and vitamin K1 [ 36 ]. Decompressive surgery may be performed in the face of a spinal subdural haematoma if deficits prevail or progress, with a high recovery rate if performed within the first 72 hours [ 11 ]. Physiotherapy has proved to be an effective method of improving motor function in human patients with intramedullary haemorrhage with or without surgery [ 35 ] but in most cases, some disabilities persist [ 37 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

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Presumptive Haematomyelia Secondary to Warfarin Toxicosis in a Dog

Blanco

Moral

Mínguez

et al. 2022

Case Reports in Veterinary Medicine

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A 3-year-old male entire Boxer was presented for a 6-day history of progressive symmetric nonambulatory tetraparesis with diffuse spinal hyperesthesia. Eight days prior to admission, the dog ingested warfarin accidentally, exhibiting systemic clinical signs of intoxication 2 days later. Upon referral, the dog was nonambulatory with paretic thoracic limbs and plegia with absent nociception on pelvic limbs, spinal reflexes were decreased to absent in all four limbs, and urinary and faecal incontinence were noticed. Magnetic resonance imaging (MRI) of the cervical, thoracic, and lumbar regions of the vertebral column revealed intramedullary lesions extending from the first cervical segments to the conus medullaris consistent with extensive intramedullary haemorrhages. Despite management with vitamin K1 and physiotherapy, 6 weeks later, improvement was limited to thoracic limb motor function, and euthanasia was elected. This case reports an extensive presumptive haematomyelia with severe neurological deficits suspected to be secondary to warfarin intoxication in a dog.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Presumptive Haematomyelia Secondary to Warfarin Toxicosis in a Dog

Blanco

Moral

Mínguez

et al. 2022

Case Reports in Veterinary Medicine

View full text Add to dashboard Cite

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“…The causes for the formation of subdural hematomas are similar to epidural hematomas. Coagulopathy and iatrogenic puncture of the vertebral canal generally leads to non-traumatic acute subdural hematoma of the intra-spinal canal [12].…”

Section: Introductionmentioning

confidence: 99%

Spinal Subdural Hematoma in a Young Adult with Hemophilia A: A Case Report

Yan¹,

Ye²,

Zeng³

et al. 2020

CMR

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Hemophilia is a set of hereditary hemorrhagic disorders of coagulation-dysfunction that can cause repeated bleeding in various tissues and organs. And the patient can be disabled due to bleeding from bones, joints, and soft tissue, or die due to splenic rupture or intracranial bleeding. So it is crucial to detect the site of bleeding in hemophilia patients quickly. Spontaneous spinal canal hematoma is a rare complication of hemophilia, with less than 50 cases reported to date. It can be easily missed and cause serious harm to patients. Hematoma, if untreated, causes irreversible nerve damage by compression of the spinal cord. Early recognition and treatment are most useful to prevent spontaneous spinal canal hematoma. We describe the case of a 21-year-old man with severe lumbago for two days, who had hemophilia A for a decade. The patient was diagnosed with spinal subdural hematoma by magnetic resonance imaging (MRI) after ruling out other causes of lumbago and treated with drugs by a neurologist. The hematoma showed absorption by MRI after six months. In conclusion, spontaneous spinal canal hematoma is a severe complication of hemophilia, which is often missed. This successful case confirms the importance of early diagnosis and treatment of spontaneous spinal canal hematoma. We hope to increase the clinicians' vigilance of this disease.

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2019

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Multiple Spinal Chronic Subdural Hematomas Associated with Thoracic Hematomyelia: A Case Report and Literature Review

Cited by 4 publications

References 48 publications

Presumptive Haematomyelia Secondary to Warfarin Toxicosis in a Dog

Presumptive Haematomyelia Secondary to Warfarin Toxicosis in a Dog

Spinal Subdural Hematoma in a Young Adult with Hemophilia A: A Case Report

Warfarin

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