title: Spine subdural hematoma: a rare complication associated with vitamin K antagonist (VKA).
abstract: 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.
authors.affiliation: Hospital Villa Lobos, Rua Artur de Almeida 167, Vila Mariana, São Paulo, SP, Brazil. uriflato@cardiol.br
authors.forename: Uri Adrian Prync
authors.initials: UA
authors.lastname: Flato
authors.forename: Paulo Sérgio
authors.initials: PS
authors.lastname: Rheder
authors.forename: Helio Penna
authors.initials: HP
authors.lastname: Guimarães
authors.forename: Elias Silva
authors.initials: ES
authors.lastname: Flato
authors.forename: Paulo
authors.initials: P
authors.lastname: Cretella
mesh_terms: 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*
chemical_list: D000925:Anticoagulants; D014812:Vitamin K