Spontaneous epidural hemorrhage in chronic renal failure

Abstract

Spontaneous epidural hemorrhage has been described in a variety of clinical scenarios, including chronic renal failure (CRF). During hemodialysis, patients with CRF rarely develop spinal or cranial epidural hematomas. Such hemorrhages have been attributed to intracranial pressure fluctuations during hemodialysis, heparin administration, uremic-platelet syndrome, or hypertension. Although the exact pathophysiology is not understood, this rare consequence of hemodialysis has been well documented in the literature. Hemorrhage in the absence of hemodialysis therapy in a CRF patient, however, has not been previously reported. We report a 16-year-old boy with no history of trauma who woke in the morning with severe headache and resultant neurological deterioration. He was found to have a large left temperoparietal epidural hematoma and underwent urgent surgical evacuation. Postoperatively he developed a contralateral extra-axial hematoma that did not require surgical intervention. He recovered completely, with no significant neurological deficit. This unique presentation of spontaneous intracranial epidural hemorrhage in an adolescent not receiving hemodialysis highlights a rare, but serious, complication of CRF.

Spontaneous intracranial epidural hematoma during rivaroxaban treatment

“…Until this date, only 20 cases were documented in the literature. [3][4][5][6]10 Hematologic abnormalities are associated with up to 8% of all intracerebral hemorrhage cases, including anticoagulant-induced coagulopathy. 11 Bleeding events are the most frequent adverse reactions associated with oral anticoagulants.…”

A review of spontaneous intracranial extradural hematoma in sickle-cell disease

“…Non-traumatic intracranial extradural hematomas (EDHs) are rare, and reports have associated their etiology with infections [3,9,14,20,25,29,31,33,37], coagulation disorders [39,43], hemodialysis, cardiac surgery [28,38], neoplasms [6,15,18,22,41], and vascular malformations [35]. The first case report of a spontaneous EDH was described in 1951 [37].…”

A Spontaneous Spinal Epidural Hematoma in a Hemodialysis Patient: A Rare Entity

“…Although some investigators found no statistically significant relation, hypertension can be responsible for the development of the SSEH (7,8 (2,3,5,8). But there are several reports in the literature that include conservative treatment (2,3,14).…”