AI Article Synopsis
- Spontaneous spinal epidural hematomas are uncommon, but vitamin K antagonist therapy is a known risk factor for their occurrence.
- A case is presented involving a patient treated with dabigatran, a non-vitamin K oral anticoagulant, who experienced a hematoma that initially led to misleading hemiparesis symptoms, later identified as Brown-Séquard syndrome.
- The patient's complete neurologic recovery was achieved after immediate administration of idarucizumab, followed by a surgical procedure (posterior cervical laminectomy), highlighting the need for specific antidotes for non-vitamin K anticoagulants.
Article Abstract
Background: While spontaneous spinal epidural hematomas are rare, 1 of the identified risk factors is vitamin K antagonist therapy.
Case Description: We present a case of a spontaneous spinal epidural hematoma occurring in a patient under treatment with dabigatran, a non-vitamin K oral anticoagulant. The initial hemiparesis symptom was misleading and was retrospectively identified as Brown-Séquard syndrome. Immediate dabigatran antagonism with idarucizumab followed by posterior cervical laminectomy permitted a complete neurologic recovery at day 4.
Conclusions: This is the first description of a spontaneous spinal epidural hematoma under non-vitamin K antagonist oral anticoagulant therapy that has been successfully antagonized and emphasizes the importance of specific antidote development.
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| http://dx.doi.org/10.1016/j.wneu.2018.01.199 | DOI Listing |
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