Herpes Zoster Infection and Use of Oral Anticoagulants

Abstract

ORAL ANTICOAGULANTS are currently approved for the secondary prophylactic treatment of venous thrombosis and pulmonary embolism and for the cerebral thromboembolic complications that typically result from mitral valve disease with atrial fibrillation. Hemorrhagic episodes are the main untoward effects caused by therapy with these agents. Accordingly, their usage must be carefully monitored by the determination of the one-stage prothrombin time. However, bleeding may occur even when this time is within the accepted therapeutic range. Spinal subdural hematomata are rare neurosurgical emergencies. These have been described as a complication of anticoagulant therapy, following spinal injury, or as being "spontaneous" in origin.^1,2A patient receiving oral anticoagulants had development of an acute spinal subdural hematoma and subarachnoid hemorrhage during the course of a thoracic level herpes zoster infection. The clinical presentation and subsequent course suggested to us the potentially dangerous association of herpes zoster infection and anticoagulant therapy. <h3>Report of a</h3>