Spine subdural hematoma: a rare complication associated with vitamin K antagonist (VKA).
Spinal subdural hematoma (SSDH) is a rare condition, which is difficult to diagnose, related to Vitamin K Antagonist. This a case report of a life-threatening situation in a octogenarian patient with a history of recent atrial fibrillation that received K-Vitamin Antagonist (KVA) therapy. The history and the clinical assessment were normal at the admission, associated with increase in the coagulation parameters (INR >10). Twenty-four hours after the admission, the patient developed progressive tetraparesis and a Magnetic Resonance Imaging (MRI) was performed, disclosing the evidence of a SSDH (Figure 1). An emergency neurosurgical intervention was performed associated with normalization of the coagulation parameters. After the procedure, the patient presented improvement of the neurological symptoms.
Flato
Uri Adrian Prync
UA
Hospital Villa Lobos, Rua Artur de Almeida 167, Vila Mariana, São Paulo, SP, Brazil. uriflato@cardiol.br
Rheder
Paulo Sérgio
PS
Guimarães
Helio Penna
HP
Flato
Elias Silva
ES
Cretella
Paulo
P
D000284:Administration, Oral; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D046649:Hematoma, Subdural, Spinal / Q000139:chemically induced*; D006801:Humans; D008297:Male; D014812:Vitamin K / Q000037:antagonists & inhibitors*
D000925:Anticoagulants; D014812:Vitamin K