Spinal epidural hematoma following coronary thrombolysis. A case report.
A case of cervicothoracic spontaneous spinal epidural hematoma (SSEH) following coronary thrombolysis with r-TPA and intravenous heparin is reported. The clinical picture is discussed, as well as the importance of rapid neuroradiological diagnosis (with spinal MRI being the method of choice) and surgical treatment. Anyway, in these patients, thorough cardiac function evaluation and rapid correction of any clotting disorder is necessary prior to surgery. With the increasing use of fibrinolytic therapy this complication would be more frequent. This underlines the importance of prompt recognition and adequate treatment.
Cultrera
F
F
Division of Neurosurgery, Cannizzaro Hospital, Catania, Italy. cicciocultrera@tiscalinet.it
Passanisi
M
M
Giliberto
O
O
Giuffrida
M
M
Mancuso
P
P
Ventura
F
F
D002574:Cervical Vertebrae / Q000473:pathology; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use; D006407:Hematoma, Epidural, Cranial / Q000209:etiology / Q000473:pathology*; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D013122:Spinal Diseases / Q000209:etiology / Q000473:pathology*; D013904:Thoracic Vertebrae / Q000473:pathology; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D010959:Tissue Plasminogen Activator / Q000009:adverse effects / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D006493:Heparin; D010959:Tissue Plasminogen Activator