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Tawk C, El Hajj Moussa M, Zgheib R, et al. Spontaneous epidural hematoma of the spine associated with oral anticoagulants: 3 Case Studies. Int J Surg Case Rep. 2015;13:8-11doi: 10.1016/j.ijscr.2015.05.022.
Tawk, C., El Hajj Moussa, M., Zgheib, R., & Nohra, G. (2015). Spontaneous epidural hematoma of the spine associated with oral anticoagulants: 3 Case Studies. International journal of surgery case reports, 138-11. https://doi.org/10.1016/j.ijscr.2015.05.022
Tawk, C, et al. "Spontaneous epidural hematoma of the spine associated with oral anticoagulants: 3 Case Studies." International journal of surgery case reports vol. 13 (2015): 8-11. doi: https://doi.org/10.1016/j.ijscr.2015.05.022
Tawk C, El Hajj Moussa M, Zgheib R, Nohra G. Spontaneous epidural hematoma of the spine associated with oral anticoagulants: 3 Case Studies. Int J Surg Case Rep. 2015;13:8-11. doi: 10.1016/j.ijscr.2015.05.022. Epub 2015 May 29. PMID: 26074484; PMCID: PMC4529632.
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Int J Surg Case Rep. 2015;13:8-11. doi: 10.1016/j.ijscr.2015.05.022. Epub 2015 May 29.

Spontaneous epidural hematoma of the spine associated with oral anticoagulants: 3 Case Studies.

International journal of surgery case reports

C Tawk, M El Hajj Moussa, R Zgheib, G Nohra

Affiliations

  1. PGY4 Orthopedic Surgery, Holy Spirit University of Kaslik - CHU Notre Dame de Secours, Jbeil, Lebanon. Electronic address: [email protected].
  2. PGY1 Orthopedic Surgery, Holy Spirit University of Kaslik-CHU Notre Dames de Secours, Jbeil, Lebanon.
  3. PGY4 Radiology, Holy Spirit University of Kaslik - CHU Notre Dame de Secours, Jbeil, Lebanon.
  4. Internal medicine, Ass. Professor Holy Spirit University of Kaslik - CHU Notre Dame de Secours, Jbeil, Lebanon.

PMID: 26074484 PMCID: PMC4529632 DOI: 10.1016/j.ijscr.2015.05.022

Abstract

INTRODUCTION: Spontaneous epidural hematoma of the spine (SEHS) is an extremely rare entity. Patients known to have thrombophilia or on anticoagulant drugs are the most affected. It is generally caused by a rupture of the postero-internal vertebral venous plexus secondary to minor barotrauma such as cough, peridural catheter insertion... Early diagnosis and treatment showed to have the best outcome.

CASES REPORT: We report 3 cases of spontaneous epidural hematoma in patients treated by acenocoumarol, which occurred without any provocative factor. All 3 patients were treated with decompressive laminectomy.

DISCUSSION: We described the MRI findings and discussed the spontaneity of the entity. Our present case studies and the review of the literature showed that early diagnosis and management of SEHS can lead to improvement of the neurological state and avoid definitive motor and sensitive deficit.

CONCLUSION: This rare entity should be suspected in every acute medullary syndrome with spinal pain, motor and/or sensory deficit. In order to decrease the sequelae, neurologically unstable patients should benefit from early diagnosis and urgent surgical decompression.

Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Keywords: Acenocoumarol; Oral anticoagulants; Spontaneous epidural hematoma of the spine

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