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Spontaneous Spinal Epidural Hematoma: An Urgent Complication of Dual Antiplatelet Therapy after Percutaneous Coronary

Masashi Katagiri1, Satoru Mitomo2, Hiroto Yabushita3

  • 1Division of Cardiology, Department of Medicine, Showa University School of Medicine, Japan.

Internal Medicine (Tokyo, Japan)
|December 10, 2025
PubMed

Insights

A patient experienced chest pain and underwent stent placement for coronary artery disease. He later developed spinal epidural hematoma, requiring urgent surgery for complete neurological recovery.

Area of Science:

  • Cardiology
  • Neurology
  • Neurosurgery

Background:

  • A 68-year-old man presented with chest pain, diagnosed as non-ST-segment elevation myocardial infarction.
  • Coronary angiography revealed severe stenosis in the diagonal artery, treated with a drug-eluting stent.
  • Post-procedure, the patient developed neurological symptoms including paresthesia and back pain.

Purpose of the Study:

  • To report a rare case of spontaneous spinal epidural hematoma following percutaneous coronary intervention.
  • To highlight diagnostic challenges and the importance of timely intervention in managing this complication.

Main Methods:

  • Diagnosis of myocardial infarction via clinical presentation and angiography.
  • Treatment of coronary stenosis with a drug-eluting stent and dual antiplatelet therapy.
  • Diagnosis of spinal epidural hematoma using magnetic resonance imaging and subsequent surgical decompression.

Main Results:

  • Successful stenting of the diagonal artery.
  • Development of left upper extremity paresthesia and persistent back pain post-procedure.
  • Complete resolution of neurological symptoms after urgent surgical decompression for spinal epidural hematoma.

Conclusions:

  • Spontaneous spinal epidural hematoma is a rare but serious complication that can occur after percutaneous coronary intervention.
  • Early diagnosis and prompt surgical intervention are crucial for favorable neurological outcomes.
  • Multidisciplinary collaboration between cardiology, neurology, and neurosurgery is essential in managing such complex cases.

Keywords:
NSTEMIdual antiplatelet treatmentspontaneous spinal epidural hematoma

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