Abstract
A case of spontaneous, atraumatic subdural haematoma involving thoracic region in a 78-year-old woman on an anticoagulant therapy (Warfarin) for atrial fibrillation presented. This patient initially presented with sudden onset headache and giddiness (signs of increased intracranial pressure) followed by an acute onset neuro-deficit in lower limb. After appropriate investigations she was treated with an emergency surgical decompression of involved spinal segment. Post-operatively the patients had complete neurological recovery.
Highlights
Spontaneous spinal subdural haematoma as a result of an anticoagulant therapy is a rare cause of spinal cord compression[1]
In this report we present a patient with an anticoagulant therapy for atrial fibrillation who experienced symptoms of increased intracranial pressure and radicular symptoms related to involved spinal segment before progressing to acute spinal cord compression and leading to neurological deficit in lower limb
We report a case of spontaneous, atraumatic, spinal subdural haematoma in the thoracic region in a 78-year-old Caucasian woman of British nationality on an anticoagulant therapy for atrial fibrillation for last five years
Summary
Spontaneous spinal subdural haematoma as a result of an anticoagulant therapy is a rare cause of spinal cord compression[1]. In this report we present a patient with an anticoagulant therapy for atrial fibrillation who experienced symptoms of increased intracranial pressure and radicular symptoms related to involved spinal segment before progressing to acute spinal cord compression and leading to neurological deficit in lower limb. The patient presented to Accident &Emergency department with acute onset nausea, giddiness and headache. This was initially diagnosed as a labyrinthitis and investigated in the form of computed tomography (CT) of head which was inconclusive. The MRI scan of the spine showed epidural haematoma extending from Thoracic 3 to 12th spinal canal causing posterior compression of spinal cord (Figure 1&2). The patient had repeat MRI scan of thoracic spine six months after the decompression, which confirmed the regression of subdural haematoma (Figure 3&4)
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