Spinal Epidural Hematoma Following Thrombolytic Therapy for Acute Myocardial Infarction

Thrombolytic therapy directed to the achievement of early reperfusion in cases with acute ST elevation myocardial infarction can have significant complications which can be due to bleeding or in the form of allergic reactions. Sometimes these complications can cause mortality or significant and incapacitating morbidity which may at times surpass the risk possessed by the disease itself. We are reporting an interesting case of 63-year-old male, who presented to us with acute anterior wall myocardial infarction and developed acute onset paralysis following intravenous administration of streptokinase and heparin. MRI spine revealed spinal epidural hematoma. Patient was advised urgent surgical evacuation of hematoma, but opted for conservative management. Patient had significant residual neurological deficits at follow-up. In conclusion, spinal epidural hematoma is a rare complication following thrombolysis for acute ST elevation myocardial infarction. Though rare, high index of suspicion is required by physicians, as prompt treatment may lead to complete recovery, which otherwise can lead to debilitating neurological sequel.

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

Clark

Paradis

2002

The Journal of Emergency Medicine

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Spinal Epidural Hematoma Following Thrombolytic Therapy for Acute Myocardial Infarction

Cited by 22 publications

References 6 publications

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Neuraxial Hematoma and Paralysis After Enoxaparin Administration 3 Days After Attempted Spinal Anesthesia for Total Knee Arthroplasty

Spinal epidural hematoma – A rare and debilitating complication of thrombolytic therapy

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

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