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Park and Jeon: Spontaneous Thoracic Spinal Epidural Hematoma after Use of Anticoagulant
Original Article

Journal of Korean Spine Surg 2004;11(2):125-129.

Published online: 12 February 2004

DOI: https://doi.org/10.4184/jkss.2004.11.2.125

Spontaneous Thoracic Spinal Epidural Hematoma after Use of Anticoagulant

Heui-Jeon Park, M.D., Jong-Se Jeon, M.D.

Department of Orthopaedic Surgery, Wonju College of Medicine, Yonsei University, Wonju, Korea

Address reprint requests to Heui-Jeon Park, M.D. Department of Orthopaedic Surgery, Yonsei University, Wonju College of Medicine 162 Ilsan-dong, Wonju, Kangwon-do, Korea Tel: 82-33-741-1352, Fax: 82-33-746-7326, E-mail: par73@wonju.yonsei.ac.kr

Copyright © 2004 Korean Society of Spine Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A spinal epidural hemorrhage, secondary to thrombolytic and anticoagulative therapies, is becoming increasingly common. Urgent surgical decompression is generally warranted to preserve the neurological function. This case report describes an epidural hematoma, with neurological sequelae, in an elderly patient who received intravenous heparin therapy for about 48hrs due to unstable angina. The posterior decompression was urgently treated, but the neurological changes did not recover. The magnetic resonance imaging and operative findings are presented, along with a discussion of the anatomical and pathophysiological considerations that could lead to such a condition.

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Keywords: Thoracic spine, Epidural hematoma, A nticoagulant

REFERENCES

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jkss-11-125f1.tif
Fig. 1.
(A) Noncontrast T1-weighted sagittal magnetic resonance imaging of the thoracic spine shows a posterior epidural intermediate signal intensity at T8-L1 with mild effacement of the cord. (B) Noncontrast T2-weighted sagittal MRI shows the same epidural collection as slightly tubular high signal intensity, suggesting subacute blood. The scan also demonstrates marked signal intensity within the adjacent cord consistent with edema.
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jkss-11-125f2.tif
Fig. 2.
Noncontrast sagittal scan demonstrates the epidural clot has completely resolved, but remained signal change within the cord 10 days after onset of hemorrhages.
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