Spontaneous Cervical Spinal Epidural Hematoma Associated with Dabigatran

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Synergetic Use of Neural Precursor Cells and Self-assembling Peptides in Experimental Cervical Spinal Cord Injury

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Published on: February 23, 2015

Quentin Mathais¹, Pierre Esnault¹, Maximilien Cruc¹

¹Department of Anesthesiology and Intensive Care, Military Hospital Sainte Anne, Toulon, France.

World Neurosurgery

|February 10, 2018

Abstract

Background:

While spontaneous spinal epidural hematomas are rare, 1 of the identified risk factors is vitamin K antagonist therapy.

Case Description:

We present a case of a spontaneous spinal epidural hematoma occurring in a patient under treatment with dabigatran, a non-vitamin K oral anticoagulant. The initial hemiparesis symptom was misleading and was retrospectively identified as Brown-Séquard syndrome. Immediate dabigatran antagonism with idarucizumab followed by posterior cervical laminectomy permitted a complete neurologic recovery at day 4.

Conclusions:

This is the first description of a spontaneous spinal epidural hematoma under non-vitamin K antagonist oral anticoagulant therapy that has been successfully antagonized and emphasizes the importance of specific antidote development.

Keywords:

Anticoagulants Idarucizumab Spinal epidural hematoma

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