Spontaneous Spinal Epidural Hematoma due to Anticoagulant Therapy: A Case Report and Literature Review
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Muhammad-Shukri Muhammad Safian 1 * , Rashidah Ismail Ohnmar HTWE 2, Radhika Sridharan 3, Ping Hoe Ngu 4 * , AS Naicker 5
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1 Department of Orthopaedics, Hospital Sarikei, Jalan Rentap, 96100 Sarikei, Sarawak, MALAYSIA2 Associate Prof / Consultant Rehab Medicine Physician Rehab Medicine Unit, Department of Orthopaedic and Traumatology, Faculty of Medicine, University Kebangsaan, MALAYSIA3 Associate Prof Dr / Radiologist Radiology Unit Department of Radiology Faculty of Medicine University Kebangsaan, MALAYSIA4 House Officer, Hospital Sungai Buloh, MALAYSIA5 Professor / Consultant Rehab Medicine Physician Rehabilitation Unit, Department of Orthopaedic and Traumatology Faculty of Medicine Universiti Kebangsaan MALAYSIA* Corresponding Author

Abstract

Aims: We report a case of spontaneous spinal epidural hematoma (SSEH) that occurred in a patient on life-long warfarin following liver transplant due to decompensated liver failure secondary to primary Budd-Chiari syndrome.
Patients and Methods: Our patient presented with acute central back pain with bilateral lower limb paralysis and incontinence with neurological level of T8 American Spinal Injury Association Impairment Scale (AIS) A. There were no history of fever, trauma or straining. MRI revealed a hyper-intense lesion at level of T8 till T10 and patient underwent an urgent laminectomy which revealed an epidural hematoma at that level.
Result: Post-operatively, patient gradually improved with final neurology level at level of T9 AIS D prior to discharge.
Conclusion: A prompt diagnosis and intervention are needed in cases of SSEH to achieve a favourable outcome.

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Case Report

ELECTRON J GEN MED, Volume 17, Issue 3, June 2020, Article No: em197

https://doi.org/10.29333/ejgm/7820

Publication date: 06 Mar 2020

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