scholarly journals Spinal epidural hematoma in a patient on chronic anticoagulation therapy performing self-neck manipulation: a case report

2019 ◽  
Vol 27 (1) ◽  
Author(s):  
Jesse Cooper ◽  
Patrick Battaglia ◽  
Todd Reiter
Keyword(s):  
Cervical Spine ◽  
Epidural Hematoma ◽  
Anticoagulation Therapy ◽  
Rare Condition ◽  
Inpatient Rehabilitation ◽  
Spinal Epidural Hematoma ◽  
Case Presentation ◽  
First Case ◽  
Spinal Epidural ◽  
Neck Manipulation

Abstract Background Spinal epidural hematoma is a rare condition usually secondary to trauma and coagulopathy. To the best of our knowledge, we present the first case of a patient with an iatrogenic hypercoaguable state performing self-neck manipulation, which resulted in a spinal epidural hematoma and subsequent quadriparesis. Case presentation A 63-year-old man presented to the emergency department with worsening interscapular pain radiating to his neck 1 day after performing self-manipulation of his cervical spine. He was found to be coagulopathic upon admission, secondary to chronic warfarin therapy for the management of atrial fibrillation. Approximately 48 h after the manipulation, the patient became acutely quadriparetic and hypotensive. Urgent magnetic resonance imaging revealed a multilevel spinal epidural hematoma from the lower cervical to thoracic spine. Conclusions Partial C7, complete T1 and T2, and partial T3 bilateral laminectomy was performed for evacuation of the spinal epidural hematoma. Following a 2-week course of acute inpatient rehabilitation, the patient returned to his baseline functional status. This case highlights the risks of self-manipulation of the neck and potentially other activities that significantly stretch or apply torque to the cervical spine. It also presents a clinical scenario in which practitioners of spinal manipulation therapy should be aware of patients undergoing anticoagulation therapy.

Nontraumatic spinal epidural hematomas

1997 ◽  
Vol 38 (1) ◽  
pp. 8-13 ◽  
Author(s):  
K O. Lövblad ◽  
R. W. Baumgartner ◽  
B. D. Zambaz ◽  
L. Remonda ◽  
C. Ozdoba ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Epidural Hematoma ◽  
Anticoagulation Therapy ◽  
Spinal Epidural Hematoma ◽  
Spinal Arteriovenous Malformation ◽  
Accurate Localization ◽  
Characteristic Signal ◽  
Spinal Epidural ◽  
Signal Intensities ◽  
T2 Weighted Images

Purpose: Spinal epidural hematoma (SEH) is a rare clinical entity with a bleak outcome. The aim of our study was to establish the value of MR findings in the diagnosis of nontraumatic SEH. Material and Methods: Seven patients with nontraumatic SEH were examined by MR at 1.5 T. Two patients were under anticoagulation therapy with heparin, and 2 others were taking salicylic acid. One patient had lupus erythematodes with a marked thrombocytopenia. One patient had a spinal arteriovenous malformation. Results: MR imaging permitted the accurate localization of extradural intraspinal expansive lesions which exhibited the characteristic signal intensities of blood. Five patients underwent laminectomy and evacuation of the hematoma. In the acute phase, the hematomas appeared isointense when compared with the spinal cord on T1-weighted images and hyperintense on T2-weighted images. Later the hematomas were hyperintense on T1-weighted images and showed signals identical to those of cerebrospinal fluid (CSF) on T2-weighted images Conclusion: MR imaging established the exact diagnosis and localization of SEH in all cases. MR also can provide useful information about the age of the hematomas.

Spontaneous spinal epidural hematoma associated with thrombolysis and anticoagulation therapy: report of three cases

1998 ◽  
Vol 100 (4) ◽  
pp. 283-287 ◽  
Author(s):  
Patrick Van Schaeybroeck ◽  
Frank Van Calenbergh ◽  
Frans Van De Werf ◽  
Philippe Demaerel ◽  
Jan Goffin ◽  
...  
Keyword(s):  
Epidural Hematoma ◽  
Anticoagulation Therapy ◽  
Spinal Epidural Hematoma ◽  
Spontaneous Spinal Epidural Hematoma ◽  
Spinal Epidural

scholarly journals Spontaneous Spinal Epidural Hematoma: Report of Two Cases and Literature Review

2021 ◽  
Vol 8 (4) ◽  
pp. 198-204
Author(s):  
Duc Duy Tri Tran ◽  
Quoc Bao Nguyen ◽  
Van Tri Truong ◽  
Thai Duong Truong ◽  
Dinh Thanh Phan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Epidural Hematoma ◽  
Cord Compression ◽  
Neurological Deficits ◽  
Spinal Epidural Hematoma ◽  
Spontaneous Spinal Epidural Hematoma ◽  
Hematoma Evacuation ◽  
First Case ◽  
Spinal Epidural

Spontaneous spinal epidural hematoma (SSEH) is a rare disease but may lead to life-threatening consequences if not timely diagnosed and managed. Emergent hematoma evacuation is indicated before neurological deficits become irreversible. We report two cases. The first case was a 45-year-old man brought to hospital because of an acute onset of quadriparesis and urinary incontinence. His cervical magnetic resonance imaging (MRI) showed an epidural hematoma at the C5-C6 level with severe spinal cord compression. He underwent an emergency C5-C6 right hemi-laminotomy to remove the clot and decompress the cord. Postoperatively, his left-sided deficits immediately resolved. His urinary function returned to normal two weeks after the surgery. He could independently walk two months later. The second case was a 57-year-old man admitted to the hospital because of severe neck pain and paresthesia in both arms. He had been using an antiplatelet for two months. His MRI revealed an epidural hematoma from C2 to C4 with spinal cord compression on the right. This patient was successfully treated with conservative treatment. If SSEH is left undiagnosed and untreated, the neurological deficits may be permanent. Early emergent hematoma evacuation contributes to a favorable outcome. Conservative management is reasonable if neurological deficits are not severe.

scholarly journals Posttraumatic Late-onset Extradural Hematoma in Dorsal Spine: A Rare Presentation

2017 ◽  
Vol 51 (1) ◽  
pp. 30-32
Author(s):  
Rahul Peswani ◽  
Adarsh Trivedi
Keyword(s):  
Epidural Hematoma ◽  
Late Onset ◽  
Rare Condition ◽  
Dorsal Spine ◽  
Neurological Recovery ◽  
Spinal Epidural Hematoma ◽  
Extradural Hematoma ◽  
Rare Presentation ◽  
Epidural Catheterization ◽  
Spinal Epidural

ABSTRACT Spinal epidural hematoma is a rare condition, which may be due to trauma, coagulopathy, surgery, or epidural catheterization. Its incidence is estimated at 0.1/100,000/year. We report a case of late-onset extradural hematoma due to trauma causing compression, and was surgically evacuated followed by immediate neurological recovery of patient. How to cite this article Peswani R, Trivedi A. Posttraumatic Late-onset Extradural Hematoma in Dorsal Spine: A Rare Presentation. J Postgrad Med Edu Res 2017;51(1):30-32.

scholarly journals Epidural hematoma treated by aspiration after transforaminal epidural steroid injection - A case report -

2021 ◽  
Author(s):  
Go Eun Kim ◽  
Sung Jun Hong ◽  
Sang Soo Kang ◽  
Ho Joon Ki ◽  
Jae Hyun Park
Keyword(s):  
Epidural Hematoma ◽  
Steroid Injection ◽  
Case Reports ◽  
Rare Condition ◽  
Epidural Steroid Injection ◽  
Neurological Deficits ◽  
Spinal Epidural Hematoma ◽  
Transforaminal Epidural Steroid Injection ◽  
Epidural Steroid ◽  
Spinal Epidural

Background: Spinal epidural hematoma is rare condition that can rapidly develop into severe neurologic deficits. The pathophysiology of this development remains unclear. There are several case reports of emergency hematoma evacuations after epidural steroid injection. Case: We report on two patients who developed acute, large amounts of epidural hematoma without neurological deficits after transforaminal epidural steroid injection. After fluoroscopy guided aspiration for epidural hematoma was performed, neurological defects did not progress and the hematoma was shown to be absorbed on magnetic resonance imaging. Conclusions: These reports are believed to be the first of treating epidural hematoma occurring after transforaminal epidural steroid injection through non-surgical hematoma aspiration. If large amounts of epidural hematoma are not causing neurological issues, it can be aspirated until it is absorbed.

Recurrent Spontaneous Spinal Epidural Hematoma in a Child: First Case Report

2007 ◽  
Vol 36 (3) ◽  
pp. 177-180 ◽  
Author(s):  
Harry S. Abram ◽  
Michael J. DeLaHunt ◽  
Deborah J. Merinbaum ◽  
David N. Hammond
Keyword(s):  
Case Report ◽  
Epidural Hematoma ◽  
Spinal Epidural Hematoma ◽  
Spontaneous Spinal Epidural Hematoma ◽  
First Case ◽  
Spinal Epidural

scholarly journals Spontaneous Epidural Hematoma of the Cervical Spine Mimicking a Cerebrovascular Accident: A Case Report

2018 ◽  
Vol 37 (03) ◽  
pp. 213-216
Author(s):  
Mohammad Jamali ◽  
Sepehr Entezam ◽  
Sulmaz Ghahramani
Keyword(s):  
Case Report ◽  
Cervical Spine ◽  
Cerebrovascular Accident ◽  
Epidural Hematoma ◽  
Lower Extremities ◽  
Sudden Onset ◽  
Spinal Epidural Hematoma ◽  
Upper And Lower Extremities ◽  
The Right ◽  
Spinal Epidural

Objective The present study is a case report of a 57-year-old female with controlled hypertension who presented with spontaneous spinal epidural hematoma (SSEH) mimicking a cerebrovascular accident (CVA) and was successfully treated by surgical decompression. Methods A 57-year-old woman with a medical history of hypertension presented with a sudden onset of weakness in the right upper and lower extremities. Weakness of grade 3/5 was noted in her right upper and lower extremities, but there was no motor weakness of the right facial muscles. A magnetic resonance imaging (MRI) exam of the cervical spine revealed an epidural hematoma extending from level C5 to level C7, causing spinal cord compression. Results During surgery, a cervical spinal epidural hematoma (SEH) was evacuated. Postoperatively, the power in both limbs improved to grade 5/5 just after surgery. Conclusions A high degree of suspicion, meticulous history taking, and physical examination have a great importance in these rare conditions because anticoagulant therapy as a routine treatment for ischemic CVA could be life-threatening.

Cervical spontaneous spinal epidural hematoma with internal jugular vein thrombosis

2011 ◽  
Vol 15 (2) ◽  
pp. 187-189 ◽  
Author(s):  
Atsushi Ishida ◽  
Seigo Matsuo ◽  
Kaku Niimura ◽  
Haruko Yoshimoto ◽  
Hideki Shiramizu ◽  
...  
Keyword(s):  
Internal Jugular Vein ◽  
Epidural Hematoma ◽  
Jugular Vein ◽  
Rare Condition ◽  
Spinal Epidural Hematoma ◽  
Jugular Vein Thrombosis ◽  
Spontaneous Spinal Epidural Hematoma ◽  
Vein Thrombosis ◽  
Spinal Epidural ◽  
Time Of Admission

Spontaneous spinal epidural hematoma (SSEH) is a rare condition, and its etiology remains unclear. Spinal venous wall instability due to intravenous pressure changes and the resultant venous rupture seem to be the underlying pathophysiological mechanisms. Here, the authors report a case of posterior SSEH at the C3–5 level causing mild left hemiparesis in a previously healthy 56-year-old woman. Angiography performed at the time of admission showed left internal jugular vein (IJV) thrombotic occlusion and dilation of the surrounding venous plexus, strongly suggesting that these pathologies caused the SSEH. Furthermore, immediate MR imaging suggested severely impaired blood flow in the left IJV. The hematoma soon resolved after spontaneous IJV thrombolysis. The authors' radiological observations imply that idiopathic IJV thrombosis may cause cervical SSEH.

Sign in / Sign up

Export Citation Format

Share Document