METHODS: This case presents a 32 year old African American female on an oral anticoagulant sustaining traumatic cervical hematoma after a motor vehicle collision. Patient complained of neck, abdominal, and back pain. Imaging revealed a cervical spinal hematoma at the level of C3-C6. This case discusses the management of CEH for the general population and in the setting of anticoagulation.
CONCLUSIONS: Management of each case of CEH must be carefully considered and tailored based on their symptom presentation and progression of disease. As the use of anticoagulation including factor Xa inhibitors becomes more prevalent, there is greater need to understand the detailed pathophysiological aspect of the injuries. Targeted reversal agents such as Prothrombin Concentrate can be used for conservative treatment. Adjunct testing such as thromboelastogram can be used to help guide management.
方法:该病例介绍了一名32岁的非洲裔美国女性,在机动车碰撞后,口服抗凝剂维持外伤性宫颈血肿。病人抱怨颈部,腹部,和背部疼痛。影像学显示C3-C6水平的颈椎血肿。该病例讨论了CEH对普通人群和抗凝治疗的管理。
结论:必须根据症状表现和疾病进展仔细考虑和调整每一例CEH的管理。随着包括因子Xa抑制剂在内的抗凝药物的使用变得越来越普遍,更需要了解损伤的详细病理生理方面。靶向逆转剂如凝血酶原浓缩物可用于保守治疗。附加测试,如血栓弹力图可用于帮助指导管理。