Non traumatic spinal epidural haematoma.
N A Khalid1, N Shah2
1MBBS, MRCP, Specialist registrar, Geriatric medicine/General Internal Medicine. University hospitals of Leicester NHS trust. Leicester Royal Infirmary.
Acute Medicine
|July 2, 2020
Summary
Spinal epidural hematoma is a rare condition. This case highlights conservative management in a patient on warfarin for atrial fibrillation, presenting a unique clinical dilemma.
Area of Science:
- Neurology
- Neurosurgery
- Hematology
Background:
- Spinal epidural hematoma (SEH) is an uncommon condition.
- It can arise from trauma, surgery, epidural procedures, or coagulation disorders.
- Managing anticoagulation in patients with SEH presents a significant clinical challenge.
Purpose of the Study:
- To report a rare case of non-traumatic spinal epidural hematoma.
- To discuss the management of anticoagulation in a patient with SEH and atrial fibrillation.
- To examine treatment options for this complex clinical scenario.
Main Methods:
- Case report of a 60-year-old female patient.
- Presentation of non-traumatic leg pain and gait difficulty.
- Diagnosis confirmed by Magnetic Resonance Imaging (MRI) of the spine.
- Conservative management approach adopted.
Main Results:
- Magnetic Resonance Imaging (MRI) revealed a spinal epidural hematoma.
- The patient was treated conservatively for the hematoma.
- The case highlights the dilemma of continuing anticoagulation for atrial fibrillation (AF).
Conclusions:
- Conservative management can be effective for non-traumatic spinal epidural hematoma.
- Careful consideration of anticoagulation is crucial in patients with atrial fibrillation and SEH.
- Further examination of management strategies for anticoagulated patients with SEH is warranted.
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