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Spinal epidural hematoma following tissue plasminogen activator and heparinization for acute myocardial infarction

Kuei-Chuan Chan1, Der-Jinn Wu, Kwo-Chang Ueng

  • 1Department of Internal Medicine, Chung-Shan Medical University Hospital, Taichung, Taiwan.

Japanese Heart Journal
|September 14, 2002
PubMed

The case of a 43-year-old Taiwanese man who presented with spinal epidural hematoma following intravenous administration of recombinant tissue plasminogen activator (rTPA) and heparin therapy for acute myocardial infarction (AMI) is reported. Upper back pain and progressive neurological dysfunction ensued, secondary to spinal epidural hematoma with spinal cord compression. The patient did not recover neurologic function postsurgically, possibly because the operation was delayed. In conclusion, cardiologists should be alert to this rare, severe complication of rTPA and should perform early laminectomy (in < or = 36 hours for those with complete deficit and in < or = 48 hours for those with incomplete deficit) if possible.

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