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Development of cervical subarachnoid hematoma following coronal artery stenting for angina pectoris

Takao Yasuhara1, Yasuyuki Miyoshi, Isao Date

  • 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. tyasu37@cc.okayama-u.ac.jp

Neurologia Medico-Chirurgica
|September 28, 2011
PubMed

Insights

A rare cervical spine subarachnoid hematoma (SAH) occurred after coronary stenting. Prompt surgical decompression improved neurological deficits, highlighting the need to consider spinal hematoma in patients on anticoagulants.

Area of Science:

  • Neurosurgery
  • Cardiology
  • Radiology

Background:

  • Coronary stenting is a common procedure for angina pectoris.
  • Subarachnoid hemorrhage (SAH) is a rare but serious complication.
  • Anti-platelet and anti-coagulant medications increase bleeding risk.

Observation:

  • A 78-year-old man developed persistent shoulder pain after coronary stenting.
  • He subsequently presented with left hemiparesis and worsening pain.
  • Imaging confirmed a massive cervical spine subarachnoid hematoma.

Findings:

  • The cervical subarachnoid hematoma was diagnosed 6 hours post-stenting.
  • Emergent hematoma evacuation and laminoplasty were performed.
  • Neurological deficits, including hemiparesis, showed improvement post-surgery.

Implications:

  • Spinal hematoma should be considered in patients on anticoagulant/anti-platelet therapy presenting with neurological deficits.
  • Early diagnosis and surgical intervention are crucial for favorable outcomes.
  • This case underscores the importance of multidisciplinary care in managing complex cardiovascular and neurological complications.

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