Türk Nöroşirürji Dergisi 2014 , Vol 24 , Num 1
Spontaneous Thoracic Spinal Epidural Haematoma in Which Paraplegia Developed as a Result of Anticoagulant and Antiplatelet Drug Use: A Case and Review
Selim KAYACI1, Kadir KOTİL2
1Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı, Rize, Türkiye
2Arel Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı, İstanbul, Türkiye
Spontaneous spinal epidural haematoma (SSEH) is a rare condition but can lead to an urgent neurosurgical clinical picture and morbidity. The clinical picture is characterized by progressive motor and sensory deficit and impaired bladder function depending on spinal cord and radicular compression starting suddenly following a severe backache. We present a patient with paraplegia and spontaneous thoracic spinal epidural haematoma developing after ASA and warfarin use following open heart surgery six years ago. We reviewed 28 cases where spontaneous spinal epidural haematoma developed while on oral anticoagulant and antiplatelet drug use in the last 30 years in the literature. Some parameters such as the treatment used (surgical or conservative), duration between the beginning of symptoms and the treatment, age, type and localisation of the haematoma were evaluated. Neurologic conditions before and after treatment were assessed according to the American Spinal Injury Association (ASIA) Scale. We discussed the subject with the literature as it is still of interest and acute backache and lumbar pain in patients using anticoagulants and antiplatelets necessitates urgent diagnosis and treatment. Anahtar Kelimeler : Magnetic resonance imaging, Thoracic spinal epidural haematoma, Paraplegia