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

https://doi.org/10.1016/j.ijscr.2015.05.022Get rights and content
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Highlights

  • Spontaneous epidural hematoma of the spine (SEHS) is an extremely rare entity.

  • Early diagnosis and treatment showed to have the best outcome.

  • SESH should be suspected in every acute medullary syndrome with spinal pain, motor and/or sensory deficit.

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.

Keywords

Spontaneous epidural hematoma of the spine
Oral anticoagulants
Acenocoumarol

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