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Revista Portuguesa de Ortopedia e Traumatologia

On-line version ISSN 1646-2939


PINHEIRO, Ana et al. Hematoma subdural espinal agudo após episódio de esforço em paciente hipocoagulado. Rev. Port. Ortop. Traum. [online]. 2016, vol.24, n.3, pp.208-214. ISSN 1646-2939.

Spinal subdural hematoma (SSH) is a rare entity, with a higher incidence among patients with bleeding diathesis. The authors report the case of a patient on anticoagulant therapy in the context of atrial fibrillation, presenting with sudden onset of dorsal and lumbar pain radiated to the anterior abdomen and both lower limbs, and progressive paraplegia of the lower limbs. Computed tomography identified a lengthwise hypodense image within the dural sac. The patient performed a nuclear magnetic resonance that revealed an extensive intradural extramedullary hematoma. After the reversal of anticoagulation and appropriate surgical treatment, the progression of the disease was unfavorable, having been the patient developed a cerebral spontaneous arachnoid hemorrhage and died. The objective of this work is to draw attention to this rare complication resulting from anticoagulant therapy. The SSH are rare, but with a tendency to increase due to the increased number of patients on anticoagulant therapy and greater accessibility to complementary diagnostic tests. The study and treatment of this disease are critical because recovery is inversely related to the duration of spinal cord compression. The SSH is a surgical emergency and, although rare, should be taken into account in the evaluation of sudden back pain with neurological deficits, especially in patients with anticoagulant therapy.

Keywords : Subdural hematoma/chemically induced; Anticoagulants/adverse effects; subdural hematoma/complications; Warfarin/adverse effects.

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