Neurol. praxi. 2017;18(6):389-393 | DOI: 10.36290/neu.2017.116

Spontaneous spinal epidural hematoma as a possible complication of anticoagulant therapy

MUDr. Karel Brabec, MUDr. Lenka Jelínková, prof. MUDr. Ivana Štětkářová, CSc.

Neurologická klinika 3. LF UK a FNKV, Praha

Spontaneous spinal epidural hematomas (SSEH) are a rare nosologic unit among the spinal canal expansions. The first clinicalmanifestation of SSEH is usually a sudden acute pain in the back which is accompanied by neurological symptoms from the compressionof structures located within the spinal canal. Therefore almost any type of spinal cord or radicular lesion can appear inthe initial stage. Anticoagulant therapy is nowadays widespread from a variety of indications, especially in elderly patients whoalso have greater risks of complications of any treatment. SSEH belongs to very rare complication of this therapy. Magnetic resonanceimaging is a key morphological method for its detection. The surgical approach remains the gold standard, but in smallerhematomas conservative approach can be also used. We present a group of 5 patients who were diagnosed and treated at ourclinic due to SSEH. Four patients used anticoagulant therapy. In one patient arterial hypertension was an only risk factor and hisclinical manifestation of SSEH was significantly milder than in others. The set of our patients corresponds to the knowledge ofspontaneous spinal epidural hematomas available in the current literature.

Keywords: spontaneous spinal epidural hematoma, SSEH, pain, spinal compression, anticoagulant therapy, warfarin

Published: December 1, 2017  Show citation