ACUTE NONTRAUMATIC SPINAL INTRADURAL HEMATOMA IN A PATIENT ON WARFARIN

被引：25

作者：

Bruce-Brand, Robert A. ^{[1
]}

Colleran, Gabrielle C. ^{[2
]}

Broderick, James M. ^{[1
]}

Lui, Darren F. ^{[1
]}

Smith, Eimear M. ^{[3
]}

Kavanagh, Eoin C. ^{[2
]}

Poynton, Ashley R. ^{[1
]}

机构：

[1] Mater Misericordiae Univ Hosp, Dept Trauma & Orthopaed Surg, Dublin, Ireland

[2] Mater Misericordiae Univ Hosp, Dept Radiol, Dublin, Ireland

[3] Natl Rehabil Ctr, Dublin, Ireland

来源：

JOURNAL OF EMERGENCY MEDICINE | 2013年 / 45卷 / 05期

关键词：

spinal intradural extramedullary hematoma; spinal subdural hematoma; spinal subarachnoid hemorrhage; spinal cord compression; SUBDURAL-HEMATOMA;

D O I：

10.1016/j.jemermed.2013.04.048

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background: Nontraumatic spinal intradural extramedullary hematomas are extremely rare. When they occur, they can rapidly lead to spinal cord or cauda equina compression and have devastating consequences. Objective: The aim here was to report a case of this rare phenomenon and discuss the etiology, imaging, management, and outcome of intradural hematomas. Case Report: We describe the case of a 76-year-old man on warfarin therapy who presented with severe lower back pain and flaccid paraparesis. Blood tests revealed an international normalized ratio of 6.0. A magnetic resonance imaging result suggested an intradural hematoma extending from L1 to L4 and compressing the spinal cord and cauda equina. Emergency surgical decompression revealed an extensive intradural extramedullary hematoma, which was evacuated. The patient showed only minor neurologic improvement 6 months postoperatively. Conclusions: Coagulopathy-induced spinal hemorrhage should be included in the differential diagnosis for patients presenting with signs of acute spinal cord compression. (C) 2013 Elsevier Inc.

引用

页码：695 / 697

页数：3

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