Spinal epidural hematoma complicating thrombolytic therapy with tissue plasminogen activator—a case report

Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy

“…The majority of published reports involve spontaneous spinal or epidural hematomas after thrombolytic therapy. [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68] Recent cases involve thrombolysis for myocardial infarction. Bleeding has been reported at all spinal levels-cervical, thoracic, and lumbar.…”

Spinal subdural hematoma following tissue plasminogen activator treatment for acute ischemic stroke

“…In a paper of reviewing 106 cases of nontraumatic acute subdural hematoma which were reported in the international literatures between 1948 and 1998, the spinal subdural hematoma was associated with a bleeding disorder in 57 cases (54%), which was secondary to a defect in the hemostatic mechanism such as leukemia, hemophilia and thrombocytopenia in 20 cases and to anticoagulant therapy in 37 cases (35%) [17]. Recently some cases with spontaneous spinal epidural hematoma following intravenous thrombolysis for acute myocardial infarction have been reported [3][4][5][6][7][8][9][10][11][12][13]. However, there has been no report of spontaneous spinal subdural hematoma complicating thrombolytic therapy with rt-PA.…”

“…Symptomatic brain hemorrhage is the major risk associated with rt-PA treatment [2]. Some cases with spontaneous spinal epidural hematoma following intravenous thrombolysis for acute myocardial infarction have been reported [3][4][5][6][7][8][9][10][11][12][13]. However, there has been no report of spontaneous spinal hemorrhage, especially of the subdural type, complicating thrombolytic therapy with rt-PA for acute ischemic stroke.…”

Spontaneous spinal epidural hematoma: An urgent complication of adding clopidogrel to aspirin therapy

“…Though controversial, some risk factors, including anticoagulant therapy [16][17][18], aspirin [16,[19][20][21], clopidogrel [6][7][8], coronary thrombolysis [12,16,22], hypertension [16,[23][24][25][26] have been proposed. Because these factors frequently occur in the general population, they cannot be the only cause of SSEH, but they can play an important role in the progression of the hematoma [8,16].…”