Spontaneous Spinal Epidural Hematoma due to Anticoagulant Therapy: A Case Report and Literature Review
Muhammad-Shukri Muhammad Safian 1 * , Rashidah Ismail Ohnmar HTWE 2, Radhika Sridharan 3, Ping Hoe Ngu 4 * , AS Naicker 5
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1 Department of Orthopaedics, Hospital Sarikei, Jalan Rentap, 96100 Sarikei, Sarawak, MALAYSIA
2 Associate Prof / Consultant Rehab Medicine Physician Rehab Medicine Unit, Department of Orthopaedic and Traumatology, Faculty of Medicine, University Kebangsaan, MALAYSIA
3 Associate Prof Dr / Radiologist Radiology Unit Department of Radiology Faculty of Medicine University Kebangsaan, MALAYSIA
4 House Officer, Hospital Sungai Buloh, MALAYSIA
5 Professor / Consultant Rehab Medicine Physician Rehabilitation Unit, Department of Orthopaedic and Traumatology Faculty of Medicine Universiti Kebangsaan MALAYSIA
* Corresponding Author


Aims: We report a case of spontaneous spinal epidural hematoma (SSEH) that occurred in a patient on life-long warfarin following liver transplant due to decompensated liver failure secondary to primary Budd-Chiari syndrome.
Patients and Methods: Our patient presented with acute central back pain with bilateral lower limb paralysis and incontinence with neurological level of T8 American Spinal Injury Association Impairment Scale (AIS) A. There were no history of fever, trauma or straining. MRI revealed a hyper-intense lesion at level of T8 till T10 and patient underwent an urgent laminectomy which revealed an epidural hematoma at that level.
Result: Post-operatively, patient gradually improved with final neurology level at level of T9 AIS D prior to discharge.
Conclusion: A prompt diagnosis and intervention are needed in cases of SSEH to achieve a favourable outcome.


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Article Type: Case Report


ELECTRON J GEN MED, 2020 - Volume 17 Issue 3, Article No: em197

Publication date: 06 Mar 2020

Article Views: 971

Article Downloads: 805

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