Tags

Type your tag names separated by a space and hit enter

Warfarin-related epidural hematoma: a case report.
J Int Med Res. 2022 Mar; 50(3):3000605221082891.JI

Abstract

Spinal epidural hematomas are rare, with trauma being the most common cause. Spinal epidural hematomas caused by coagulation dysfunction are even rarer; however, long-term warfarin therapy increases the risk. The clinical manifestations of spinal epidural hematoma are neurological deficits below the corresponding spinal cord segment level. Magnetic resonance imaging (MRI) is the preferred method for diagnosis, and the main treatment for epidural hematoma with typical symptoms is urgent decompression of the lumbar spine. We describe an almost 80-year-old female patient who received long-term oral warfarin therapy for atrial fibrillation. She developed sudden onset waist pain, and 2 days later, she developed pain and weakness in both lower limbs. Computed tomography (CT) of the thoracolumbar spine showed no obvious hematoma. Eight days after admission, contrast-enhanced CT of the thoracolumbar spine showed intraspinal hematomas at T5-T8 and T12-L2 levels. We performed T3-T7 laminectomy, T5-T8 hematoma removal, and spinal dural repair. The clinical symptoms did not improve significantly, postoperatively. The low incidence of spinal epidural hematoma after anticoagulation treatment means this condition is not recognized timely, and it is misdiagnosed easily. Clinicians should consider this condition when patients treated with anticoagulants have neurological deficits below a spinal segmental plane.

Authors+Show Affiliations

Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.Department of Neurosurgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

35317631

Citation

Li, Xiaoting, et al. "Warfarin-related Epidural Hematoma: a Case Report." The Journal of International Medical Research, vol. 50, no. 3, 2022, p. 3000605221082891.
Li X, Zeng Z, Yang Y, et al. Warfarin-related epidural hematoma: a case report. J Int Med Res. 2022;50(3):3000605221082891.
Li, X., Zeng, Z., Yang, Y., Ding, W., Wang, L., Xu, Y., Yang, W., & Bi, W. (2022). Warfarin-related epidural hematoma: a case report. The Journal of International Medical Research, 50(3), 3000605221082891. https://doi.org/10.1177/03000605221082891
Li X, et al. Warfarin-related Epidural Hematoma: a Case Report. J Int Med Res. 2022;50(3):3000605221082891. PubMed PMID: 35317631.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Warfarin-related epidural hematoma: a case report. AU - Li,Xiaoting, AU - Zeng,Zhaohao, AU - Yang,Ying, AU - Ding,Weilong, AU - Wang,Lu, AU - Xu,Yezi, AU - Yang,Wei, AU - Bi,Wei, PY - 2022/3/23/entrez PY - 2022/3/24/pubmed PY - 2022/3/25/medline KW - Warfarin KW - anticoagulation therapy KW - contrast-enhanced CT KW - epidural hematoma KW - incidence KW - neurological deficit KW - spinal canal surgery KW - symptom SP - 3000605221082891 EP - 3000605221082891 JF - The Journal of international medical research JO - J Int Med Res VL - 50 IS - 3 N2 - Spinal epidural hematomas are rare, with trauma being the most common cause. Spinal epidural hematomas caused by coagulation dysfunction are even rarer; however, long-term warfarin therapy increases the risk. The clinical manifestations of spinal epidural hematoma are neurological deficits below the corresponding spinal cord segment level. Magnetic resonance imaging (MRI) is the preferred method for diagnosis, and the main treatment for epidural hematoma with typical symptoms is urgent decompression of the lumbar spine. We describe an almost 80-year-old female patient who received long-term oral warfarin therapy for atrial fibrillation. She developed sudden onset waist pain, and 2 days later, she developed pain and weakness in both lower limbs. Computed tomography (CT) of the thoracolumbar spine showed no obvious hematoma. Eight days after admission, contrast-enhanced CT of the thoracolumbar spine showed intraspinal hematomas at T5-T8 and T12-L2 levels. We performed T3-T7 laminectomy, T5-T8 hematoma removal, and spinal dural repair. The clinical symptoms did not improve significantly, postoperatively. The low incidence of spinal epidural hematoma after anticoagulation treatment means this condition is not recognized timely, and it is misdiagnosed easily. Clinicians should consider this condition when patients treated with anticoagulants have neurological deficits below a spinal segmental plane. SN - 1473-2300 UR - https://www.unboundmedicine.com/medline/citation/35317631/Warfarin_related_epidural_hematoma:_a_case_report_ DB - PRIME DP - Unbound Medicine ER -