%0 Case Reports
%T Spontaneous spinal epidural hematoma in a patient on acenocoumarol for valvular atrial fibrillation: A rare case report.
%A El-Azrak M
%A Noumairi M
%A Oulalite MA
%A El Mir S
%A Kachmar S
%A Bkiyar H
%A El Ouafi N
%A El Oumri AA
%A Bazid Z
%A Housni B
%J Ann Med Surg (Lond)
%V 72
%N 0
%D Dec 2021
%M 34876979
暂无%R 10.1016/j.amsu.2021.103076
%X <B>BACKGROUND: </B>Spontaneous spinal epidural hematoma (SSEH) is a rare finding, but one with serious clinical implications. Oral anticoagulant drugs are known to be associated with the SSEH onset, particularly when combined with drugs increasing the bleeding risk.<BR><B>METHODS: </B>We present the case of a 62-year-old female on acencoumarol for her atrial fibrillation complicating severe mitral stenosis with a history of Ketoprofen use for the onset of her first symptoms. She presented to our emergency room with paraplegia and sphincter disturbance. Spinal magnetic resonance imaging (MRI) revealed a posterior SSEH extended from T10 to T12 requiring an urgent decompression of the spinal cord by laminectomy performed within 48 hours from the symptom's onset. After 3 months of rehabilitation, the patient improves partially her muscular strength with mostly unchanged sensitive and sphincteric levels.<BR><B>UNASSIGNED: </B>Vitamin K antagonists (VKA) use appears to be a high suspicion index for SSEH diagnosis resulting in earlier surgery and improving neurological outcome. Also, it is important to pay attention to the concomitant use of VKA and non-steroidal anti-inflammatory drugs which increase the risk of bleeding and may worsen the neurological outcome.<BR><B>CONCLUSIONS: </B>SSEH is a rare and serious finding which should be especially searched when a history of oral anticoagulation is reported in presence of neurological symptoms. A prompt and suitable management may improve the patient outcomes.