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Spontaneous spinal epidural hematoma associated with thrombolysis and anticoagulation therapy: report of three cases.
Clin Neurol Neurosurg. 1998 Dec; 100(4):283-7.CN

Abstract

Three patients with a spontaneous spinal epidural hematoma are presented, one of which is exceptional because it could be attributed to thrombolysis with alteplase. The other two were correlated with oral anticoagulant therapy. Our second case suggests that Morbus Kahler may be an underlying pathology in spinal extradural hematoma. In the third patient neither an obvious 'locus minoris resistentiae' nor a pathological coagulation test could be held responsible for the spontaneous bleeding. All three patients underwent laminectomy and evacuation of the hematoma. Although two of our cases are examples of complete recuperation after late operative intervention, early surgery is preferable. Permanent clinical attention together with a low threshold to perform magnetic resonance imaging (MRI) leads to a quicker diagnosis of spinal epidural hematoma. We show that administration of gadolinium may facilitate correct preoperative localization of the hematoma because there may be contrast enhancement of the hematoma. Finally, the postoperative policy concerning thromboembolic prophylaxis is discussed.

Authors+Show Affiliations

Department of Neurosurgery, University Hospital Leuven, Belgium.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9879854

Citation

Van Schaeybroeck, P, et al. "Spontaneous Spinal Epidural Hematoma Associated With Thrombolysis and Anticoagulation Therapy: Report of Three Cases." Clinical Neurology and Neurosurgery, vol. 100, no. 4, 1998, pp. 283-7.
Van Schaeybroeck P, Van Calenbergh F, Van De Werf F, et al. Spontaneous spinal epidural hematoma associated with thrombolysis and anticoagulation therapy: report of three cases. Clin Neurol Neurosurg. 1998;100(4):283-7.
Van Schaeybroeck, P., Van Calenbergh, F., Van De Werf, F., Demaerel, P., Goffin, J., & Plets, C. (1998). Spontaneous spinal epidural hematoma associated with thrombolysis and anticoagulation therapy: report of three cases. Clinical Neurology and Neurosurgery, 100(4), 283-7.
Van Schaeybroeck P, et al. Spontaneous Spinal Epidural Hematoma Associated With Thrombolysis and Anticoagulation Therapy: Report of Three Cases. Clin Neurol Neurosurg. 1998;100(4):283-7. PubMed PMID: 9879854.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spontaneous spinal epidural hematoma associated with thrombolysis and anticoagulation therapy: report of three cases. AU - Van Schaeybroeck,P, AU - Van Calenbergh,F, AU - Van De Werf,F, AU - Demaerel,P, AU - Goffin,J, AU - Plets,C, PY - 1999/1/8/pubmed PY - 1999/1/8/medline PY - 1999/1/8/entrez SP - 283 EP - 7 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 100 IS - 4 N2 - Three patients with a spontaneous spinal epidural hematoma are presented, one of which is exceptional because it could be attributed to thrombolysis with alteplase. The other two were correlated with oral anticoagulant therapy. Our second case suggests that Morbus Kahler may be an underlying pathology in spinal extradural hematoma. In the third patient neither an obvious 'locus minoris resistentiae' nor a pathological coagulation test could be held responsible for the spontaneous bleeding. All three patients underwent laminectomy and evacuation of the hematoma. Although two of our cases are examples of complete recuperation after late operative intervention, early surgery is preferable. Permanent clinical attention together with a low threshold to perform magnetic resonance imaging (MRI) leads to a quicker diagnosis of spinal epidural hematoma. We show that administration of gadolinium may facilitate correct preoperative localization of the hematoma because there may be contrast enhancement of the hematoma. Finally, the postoperative policy concerning thromboembolic prophylaxis is discussed. SN - 0303-8467 UR - https://www.unboundmedicine.com/medline/citation/9879854/Spontaneous_spinal_epidural_hematoma_associated_with_thrombolysis_and_anticoagulation_therapy:_report_of_three_cases_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0303846798000444 DB - PRIME DP - Unbound Medicine ER -