Spontaneous Spinal Epidural Hematoma Under Rivaroxaban and Clopidogrel: A Case Report and Literature Review

Spontaneous Spinal Epidural Hematoma Under Rivaroxaban and Clopidogrel: A Case Report and Literature Review

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Bruno Schoenmaekers,1 Imad Derraz,2 Nadim Tahhan,3 Pierre Metrailler1 1Emergency Department, Centre Hospitalier du Valais turbo air m3f72-3-n Romand (CHVR), Sion, Switzerland; 2Department of Radiology, Centre Hospitalier du Valais Romand (CHVR), Sion, Switzerland; 3Neurosurgery Department, Centre Hospitalier du Valais Romand (CHVR), Sion, SwitzerlandCorrespondence: Bruno Schoenmaekers, Centre Hospitalier du Valais Romand (CHVR), Emergency Department, Avenue du Grand-Champsec 80, Sion, 1951, Switzerland, Email [email protected]: Spontaneous spinal epidural hematoma (SSEH) is a rare pathology with potentially severe consequences for the patient.Given its uncommon incidence and frequent atypical presentation, SSEH can easily be misdiagnosed.The association between anticoagulation or antiplatelet therapy and SSEH has been described in multiple case reports and literature reviews.We present a case of a 61-year-old man on anticoagulation and antiplatelet therapy (Rivaroxaban and Clopidogrel respectively), diagnosed with spinal SSEH with good recovery after laminectomy and hematoma evacuation.

However, treatment guidelines for SSEH are difficult to find and princess polly dresses long sleeve there is no clear strategy about management of anticoagulation and antiplatelet therapy.The aim of this report is to highlight the importance of rapid diagnosis and surgical therapy in selected cases and to give an insight on the anticoagulation and antiplatelet management in these patients and their prognosis.Keywords: neurosurgery, anticoagulation, platelet inhibitors, treatment, prognosis.