Related Experiment Video
Updated: May 8, 2026

Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
Acute nontraumatic spinal intradural hematoma in a patient on warfarin
Robert A Bruce-Brand1, Gabrielle C Colleran, James M Broderick
1Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
Background:
Nontraumatic spinal intradural extramedullary hematomas are extremely rare. When they occur, they can rapidly lead to spinal cord or cauda equina compression and have devastating consequences.
Objective:
The aim here was to report a case of this rare phenomenon and discuss the etiology, imaging, management, and outcome of intradural hematomas.
Case Report:
We describe the case of a 76-year-old man on warfarin therapy who presented with severe lower back pain and flaccid paraparesis. Blood tests revealed an international normalized ratio of 6.0. A magnetic resonance imaging result suggested an intradural hematoma extending from L1 to L4 and compressing the spinal cord and cauda equina. Emergency surgical decompression revealed an extensive intradural extramedullary hematoma, which was evacuated. The patient showed only minor neurologic improvement 6 months postoperatively.
Conclusions:
Coagulopathy-induced spinal hemorrhage should be included in the differential diagnosis for patients presenting with signs of acute spinal cord compression.
Related Concept Videos
Hemorrhagic Stroke ll: Pathophysiology
Hemorrhagic Stroke l: Introduction
Venous Thrombosis III: Interprofessional Care
Venous Thrombosis IV: Nursing Management
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Anticoagulant Drugs: Low-Molecular-Weight Heparins

