Acute Spinal Extradural Hematoma and Cord Compression: Case Report and a Literature Review
Eslam Hussein Mohamed1, Landric B Dsouza1, Wael Abdelrehem Elnabawy1
1Emergency Department, Hamad Medical Corporation, Doha, QAT.
Cureus
|November 26, 2020
Summary
Dual antiplatelet therapy may increase the risk of spinal epidural hematomas, leading to acute cauda equina syndrome. This case highlights the potential link between these medications and severe neurological deficits.
Area of Science:
- Neurology
- Neurosurgery
- Pharmacology
Background:
- Dual antiplatelet therapy (DAPT) is commonly prescribed for cardiovascular conditions.
- Spinal epidural hematomas (SEHs) are rare but serious conditions causing neurological deficits.
- Cauda equina syndrome (CES) results from compression of the nerve roots in the lower spinal canal.
Observation:
- A 50-year-old male on DAPT developed sudden bilateral lower limb weakness and back pain after heavy lifting.
- MRI revealed an extensive extradural hematoma from the foramen magnum to L5, compressing the spinal cord.
- The patient presented with complete motor and sensory loss in his lower limbs, consistent with acute CES.
Findings:
- The patient's clinical presentation and MRI findings confirmed acute cauda equina syndrome.
- The extensive extradural hematoma was identified as the cause of spinal cord compression.
- The patient's history of dual antiplatelet therapy was noted as a potential contributing factor.
Implications:
- This case suggests a possible association between DAPT and the development of SEH.
- Increased awareness of this potential risk may aid in early diagnosis and management of CES.
- Further research is warranted to explore the clinical correlation between DAPT and spinal hematomas.
