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

Moon, Hong Joo; Kim, Joo Han; Kim, Jong Hyun; Kwon, Taek Hyun; Chung, Hung Seob; Park, Youn Kwan

doi:10.1016/j.jns.2009.06.028

Cited by 24 publications

(17 citation statements)

References 29 publications

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“…The cause of spinal epidural hematoma in 40–50% of cases is not known 2. The causes of SSEH, such as increased bleeding tendency with the use of various medications,3 blood dyscrasia,4 direct or indirect spinal trauma,5 and hypertension,6 have been discussed in published works. However, the mechanism of spinal epidural hematoma is not clear.…”

Section: Discussionmentioning

confidence: 99%

Two cases of spontaneous cervical epidural hematoma without back or neck pain in elderly Japanese men

Hongo

Iseda

Tsuchiya

et al. 2017

Acute Medicine & Surgery

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CasesSpontaneous spinal epidural hematoma (SSEH) is an uncommon disease. Most SSEH cases involve back and/or neck pain. We report the cases of two men who experienced SSEH with dysstasia but without back or neck pain.OutcomesThis study presents two cases involving elderly Japanese men who visited an emergency department because of sudden dysstasia without back or neck pain. The results of the neurological examinations revealed ataxic gait. Cervical spinal epidural hematomas were observed by computed tomography and magnetic resonance imaging. One patient underwent hematoma removal and decompression by corpectomy, whereas the other patient received conservative treatment and observation. The patients were discharged without sequelae.ConclusionSpinal epidural hematomas are difficult to diagnose, and a delayed diagnosis can adversely affect the patient's quality of life. These hematomas should be considered in the differential diagnosis of cerebrovascular diseases.

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Section: Discussionmentioning

confidence: 99%

Two cases of spontaneous cervical epidural hematoma without back or neck pain in elderly Japanese men

Hongo

Iseda

Tsuchiya

et al. 2017

Acute Medicine & Surgery

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“…Antikoagülanların aksine antiagreganlarla ilişkili SSEH çok nadirdir (8). Etiyolojide koagülopati, vasküler malformasyon, neoplazi, infeksiyon, minör vertebral travma ve idiyopatik (%40-60) nedenler yer alır (3).…”

Section: Discussionunclassified

“…Diğer nedenler ise antikoagülan tedavi, akut miyokard infarktüsü için yapılan trombolitik tedavi, hemofili B, faktör 9 eksikliği, uzun süre aspirin kullanımı, kontrol edilemeyen hipertansiyon, diyalize girme ve vasküler anomalidir(4). Ayırıcı tanıda intervertebral disk herniasyonu, spinal kord iskemisi, transvers miyelit, spinal epidural tümör veya apse, spondilit ve aortik anevrizma rüptürü düşünülmelidir (8). Patogenez tam olarak aydınlatılamasa da, suçlanan faktörler; spinal epidural boşluktaki epidural venöz pleksusun kapaklarının olmaması ve göğüs ile karın boşluğundaki ani basınç artması ile damar rüptürüne bağlı gelişen kanamadır (9).…”

Section: Discussionunclassified

“…Spinal kord basısının şiddeti ve kanamanın yerine göre klinik tablo değişkenlik gösterebilir. Ağrının nedeni de kanamaya bağlı olarak gelişen Parapleji ile prezente olan spinal epidural hematom spinal kord kompresyonudur (8). Torakal bölgedeki spontan epidural hematomlar daha semptomatik olabilmektedir çünkü anatomik olarak torakal bölge, servikal ve lomber bölgeye göre daha dardır.…”

Section: Discussionunclassified

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Spinal Epidural Hematoma Presenting with Paraplegia: Two Different Etiologies and Treatment Approaches

Akpınar¹,

Doğru²,

Balcı³

et al. 2017

Türk Beyin Damar Hast Derg

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“…SSEH of idiopathic origin is most frequently observed and accounts for 40% - 50% of spinal epidural hematomas (4). Other secondary causes, such as an increased bleeding tendency for various medications (5), blood dyscracia (6), direct or indirect spinal trauma (7), hypertension (8), and pregnancy (9), have been discussed in the literature.…”

Section: Discussionmentioning

confidence: 99%

Acute Cervical Spontaneous Spinal Epidural Hematoma Presenting with Minimal Neurological Deficits: A Case Report

et al. 2016

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IntroductionSpontaneous spinal epidural hematoma (SSEH) is an uncommon but potentially fatal condition. The increased bleeding tendency associated with anticoagulant medications has been proven to increase the risk of SSEH. The symptoms of SSEH usually begin with sudden severe neck or back pain and are followed by neurological deficits. However, some cases present with only axial pain or with radicular pain similar to herniated disc disorders.Case PresentationA 28-year-old healthy man developed a sudden onset of severe neck and right shoulder pain with mild arm weakness. The MRI revealed an SSEH that was compressing his spinal cord in the right posterolateral epidural space from C2-C6. On the second hospital day, his symptoms suddenly improved, and most of the hematoma had spontaneously resolved.ConclusionsCurrently, the incidence of SSEH is expected to increase. Pain physicians must include SSEH in their differential diagnosis for patients with axial pain or radicular symptoms alone, particularly when risk factors are present.

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

Cited by 24 publications

References 29 publications

Two cases of spontaneous cervical epidural hematoma without back or neck pain in elderly Japanese men

Two cases of spontaneous cervical epidural hematoma without back or neck pain in elderly Japanese men

Spinal Epidural Hematoma Presenting with Paraplegia: Two Different Etiologies and Treatment Approaches

Acute Cervical Spontaneous Spinal Epidural Hematoma Presenting with Minimal Neurological Deficits: A Case Report

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