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Clopidogrel-induced spontaneous spinal epidural hematoma
Jae Hoon Sung1, Jae Taek Hong, Byung Chul Son
1Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea, 93-6 Ji-dong, Paldal-gu, Suwon, Korea. jaehoonsung@gmail.com.
Journal of Korean Medical Science
|June 29, 2007
Summary
Clopidogrel, an antiplatelet medication, can rarely cause spontaneous spinal epidural hematoma (SSEH). Prompt surgical intervention for this critical side effect leads to excellent outcomes.
Area of Science:
- Neurology
- Hematology
- Pharmacology
Background:
- Clopidogrel is a widely prescribed antiplatelet agent used to prevent thrombotic events.
- Hemorrhagic side effects are known but typically localized to skin or gastrointestinal sites.
- Spinal epidural hematoma (SSEH) is a rare but serious complication associated with antiplatelet therapy.
Observation:
- A case of spontaneous spinal epidural hematoma (SSEH) is presented in a 60-year-old woman treated with clopidogrel for transient ischemic attacks.
- The patient presented with symptoms suggestive of SSEH, with a history of clopidogrel use.
- This represents the second reported instance of clopidogrel-induced SSEH.
Findings:
- Diagnosis was made based on clinical presentation and patient history.
- Surgical intervention for SSEH was performed 9 hours after the onset of paraplegia.
- The patient experienced an excellent outcome following surgical decompression.
Implications:
- Physicians must be aware of the potential for rare but critical SSEH in patients prescribed clopidogrel.
- Prompt recognition and urgent treatment of clopidogrel-induced SSEH are crucial for favorable patient outcomes.
- The increasing use of antiplatelet medications necessitates vigilance for unusual adverse events.
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