PDF(Pubmed)
Abstract：
BACKGROUND: Cervical epidural hematoma (CEH) is defined as a collection of blood in the suprameningeal space. Mechanisms of this rare pathology include spontaneous, postsurgical, and traumatic as the main subtypes. This unique case of traumatic CEH represents an even smaller subset of these cases. Management varies by symptom presentation, mechanism of injury, and other contraindications.
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.
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.
摘要：
背景：宫颈硬膜外血肿（CEH）定义为脑膜上间隙的血液收集。这种罕见病理的机制包括自发，术后,和创伤性为主要亚型。这种独特的创伤性CEH病例代表了这些病例中更小的子集。管理因症状表现而异，损伤机制,和其他禁忌症。
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。
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。
