Spontaneous spinal epidural hematoma in a patient on acenocoumarol for valvular atrial fibrillation: A rare case report

• DOI: 10.1016/j.amsu.2021.103076
• Publication Date: 2021-11-17T12:09:24Z
• Authors: Mohammed El-azrak; Mohammed Noumairi; Mohammed Amine Ou...; Siham El Mir; Safaa Kachmar; Houssam Bkiyar; Noha El Ouafi; Ahmed Amine El Oumri; Zakaria Bazid; Brahim Housni
• Keywords: Acenocoumarol

Spontaneous spinal epidural hematoma (SSEH) is a rare finding, but one with serious clinical implications. Oral anticoagulant drugs are known to be associated the SSEH onset, particularly when combined increasing bleeding risk.We present case of 62-year-old female on acencoumarol for her atrial fibrillation complicating severe mitral stenosis history Ketoprofen use onset first symptoms. She presented our emergency room paraplegia and sphincter disturbance. Spinal magnetic resonance imaging (MRI) revealed posterior extended from T10 T12 requiring an urgent decompression cord by laminectomy performed within 48 hours symptom's onset. After 3 months rehabilitation, patient improves partially muscular strength mostly unchanged sensitive sphincteric levels.Vitamin K antagonists (VKA) appears high suspicion index diagnosis resulting in earlier surgery improving neurological outcome. Also, it important pay attention concomitant VKA non-steroidal anti-inflammatory which increase risk may worsen outcome.SSEH finding should especially searched oral anticoagulation reported presence A prompt suitable management improve outcomes.