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Spontaneous Spinal Epidural Hematoma from Rivaroxaban
Charlotte Goldfine1, Catherine Glazer1, Richard M Ratzan1
1University of Connecticut School of Medicine, Hartford Hospital, Department of Emergency Medicine, Hartford, Connecticut.
Clinical Practice and Cases in Emergency Medicine
|June 1, 2018
Summary
Spontaneous spinal epidural hematoma (SSEH) is a rare condition, often linked to anticoagulation. This case highlights a patient on rivaroxaban presenting with fluctuating neurological deficits, emphasizing the need for awareness of this adverse effect.
Area of Science:
- Neurology
- Hematology
Background:
- Spontaneous spinal epidural hematoma (SSEH) is an uncommon yet serious condition.
- Anticoagulation therapy is a recognized risk factor for SSEH.
Observation:
- A 74-year-old male on rivaroxaban therapy developed SSEH.
- The patient exhibited an intermittently resolving and worsening neurological examination.
Findings:
- Rivaroxaban, a novel anticoagulant, was associated with SSEH in this case.
- The clinical presentation of SSEH can be variable and include fluctuating neurological deficits.
Implications:
- Increased awareness of SSEH presentations is crucial for timely diagnosis and management.
- Clinicians should consider SSEH as a potential adverse effect in patients on novel anticoagulation, especially those with neurological symptoms.
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