Clopidogrel-induced spontaneous spinal epidural hematoma.
The hemorrhagic side effects associated with the use of clopidogrel are within the acceptable range and occur mainly at skin or gastrointestinal sites. We report a case of spontaneous spinal epidural hematoma (SSEH) in a 60-yr-old woman who was treated with clopidogrel for frequent transient ischemic attacks. To our knowledge, this is the second reported case of clopidogrel-induced SSEH. The patient's symptoms and past history of clopidogrel use suggested the diagnosis and made the procedure proceed quickly to operate SSEH 9 hr after the onset of paraplegia. The outcome was excellent. Therefore, with the popularity of antiplatelet prescription, physicians should keep in mind and urgently treat this unusual but critical side effect.
Sung
Jae Hoon
JH
Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea, 93-6 Ji-dong, Paldal-gu, Suwon, Korea. jaehoonsung@gmail.com.
Hong
Jae Taek
JT
Son
Byung Chul
BC
Lee
Sang Won
SW
D000368:Aged; D001921:Brain / Q000473:pathology; D002533:Cerebral Angiography; D000077144:Clopidogrel; D005260:Female; D046748:Hematoma, Epidural, Spinal / Q000139:chemically induced*; D006801:Humans; D007511:Ischemia / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives*; D013997:Time Factors; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine