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Spinal Epidural Hematoma During Anticoagulant Therapy: Report of Two Cases

Spinal Epidural Hematoma During Anticoagulant Therapy: Report of Two Cases Abstract Spinal epidural hematomas have been recognized since the late 19th century as a rare cause of rapidly developing spinal cord compression. While this entity has been reported to occur spontaneously in blood dyscrasias, it has been observed recently in the treatment of cardiovascular diseases following the administration of anticoagulants. In a review of the literature, we have been able to find only 43 cases of spontaneous epidural hematoma, eight of which were associated with anticoagulant therapy. The omission of this condition in recent standard neurological textbooks seems to justify this report of two additional cases since prompt recognition and surgical intervention are essential in minimizing neurological sequelae. Report of Cases Case 1. —A 67-year-old woman with known hypertensive disease was admitted to the Menorah Medical Center, Dec 24, 1956, with a complaint of chest pain. An electrocardiogram on admission showed evidence of an acute myocardial infarction. The patient was treated References 1. Gold, E. M.: Spontaneous Spinal Epidural Hematoma , Radiology 80: 823-828, 1963.Crossref 2. Aring, C. D.: Neurological Clinical Pathological Conference of Cincinnati General Hospital , Dis Nerv Syst 13. 53-60, 1952. 3. Arieff, A. J., and Pyzik, S. W.: Paraplegia Following or Associated With Excessive Dicumarol Therapy , Quart Bull Northwest Univ Med Sch 28: 221-222, 1954. 4. Cloward, R. B., and Yuhl, E. T.: Spontaneous Intraspinal Hemorrhage and Paraplegia Complicating Dicumarol Therapy , Neurology Minneap 5: 600-602, 1955.Crossref 5. Alderman, D. B.: Extradural Spinal-Cord Hematoma: Report of Case Due to Dicumarol and Review of Literature , New Eng JMed 255: 839-842, 1956.Crossref 6. Winer, B. M.; Horenstein, S.; and Starr, A. M.: Spinal Epidural Hematoma During Anticoagulant Therapy , Circulation 19:735-740, 1959.Crossref 7. Kuznetsow, N. D.: Case of Spinal Cord Lesion Following Use of Dicoumarin , Med Zh Uzbek 5: 73-75, 1962. 8. Whaley, R. L.; and Lindner, D. W.: Spontaneous Spinal Epidural Hemorrhage Associated With Anticoagulant Therapy , Grace Hosp Bull 40: 27-32, 1962. 9. Wright, I. S.: Concerning Function and Nomenclature of Blood Clotting Factors , Ann Intern Med 51: 842-849, 1959. 10. Owren, P. A.: Indications for Anticoagulant Therapy , New Eng J Med 268: 1173-1177, 1963.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Spinal Epidural Hematoma During Anticoagulant Therapy: Report of Two Cases

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References (11)

Publisher
American Medical Association
Copyright
Copyright © 1964 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1964.03860070149019
Publisher site
See Article on Publisher Site

Abstract

Abstract Spinal epidural hematomas have been recognized since the late 19th century as a rare cause of rapidly developing spinal cord compression. While this entity has been reported to occur spontaneously in blood dyscrasias, it has been observed recently in the treatment of cardiovascular diseases following the administration of anticoagulants. In a review of the literature, we have been able to find only 43 cases of spontaneous epidural hematoma, eight of which were associated with anticoagulant therapy. The omission of this condition in recent standard neurological textbooks seems to justify this report of two additional cases since prompt recognition and surgical intervention are essential in minimizing neurological sequelae. Report of Cases Case 1. —A 67-year-old woman with known hypertensive disease was admitted to the Menorah Medical Center, Dec 24, 1956, with a complaint of chest pain. An electrocardiogram on admission showed evidence of an acute myocardial infarction. The patient was treated References 1. Gold, E. M.: Spontaneous Spinal Epidural Hematoma , Radiology 80: 823-828, 1963.Crossref 2. Aring, C. D.: Neurological Clinical Pathological Conference of Cincinnati General Hospital , Dis Nerv Syst 13. 53-60, 1952. 3. Arieff, A. J., and Pyzik, S. W.: Paraplegia Following or Associated With Excessive Dicumarol Therapy , Quart Bull Northwest Univ Med Sch 28: 221-222, 1954. 4. Cloward, R. B., and Yuhl, E. T.: Spontaneous Intraspinal Hemorrhage and Paraplegia Complicating Dicumarol Therapy , Neurology Minneap 5: 600-602, 1955.Crossref 5. Alderman, D. B.: Extradural Spinal-Cord Hematoma: Report of Case Due to Dicumarol and Review of Literature , New Eng JMed 255: 839-842, 1956.Crossref 6. Winer, B. M.; Horenstein, S.; and Starr, A. M.: Spinal Epidural Hematoma During Anticoagulant Therapy , Circulation 19:735-740, 1959.Crossref 7. Kuznetsow, N. D.: Case of Spinal Cord Lesion Following Use of Dicoumarin , Med Zh Uzbek 5: 73-75, 1962. 8. Whaley, R. L.; and Lindner, D. W.: Spontaneous Spinal Epidural Hemorrhage Associated With Anticoagulant Therapy , Grace Hosp Bull 40: 27-32, 1962. 9. Wright, I. S.: Concerning Function and Nomenclature of Blood Clotting Factors , Ann Intern Med 51: 842-849, 1959. 10. Owren, P. A.: Indications for Anticoagulant Therapy , New Eng J Med 268: 1173-1177, 1963.Crossref

Journal

Archives of Internal Medicine – American Medical Association

Published: Jul 1, 1964

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