title: Spontaneous spinal epidural haematoma after antiplatelet treatment: a report of two cases.
abstract: We report 2 cases of spontaneous spinal epidural haematoma after antiplatelet treatment. One patient was on ticlodipine therapy and the other was on aspirin and clopidogrel. Both diagnoses were made using magnetic resonance imaging. One patient underwent multilevel laminectomies and posterior spinal fusion within 24 hours of symptom onset and achieved complete neurological recovery. The other underwent unilateral hemilaminectomies 40 hours after symptom onset and did not show neurological improvement. A high index of suspicion is needed for patients presenting with severe lower back pain and rapid neurological deterioration, especially in those on antiplatelet therapy. Urgent spinal cord decompression and epidural haematoma cord evacuation may provide more favourable outcome.
authors.affiliation: Department of Orthopaedics, National University Hospital, Singapore.
authors.forename: Lushun
authors.initials: L
authors.lastname: Wang
authors.forename: Gabriel
authors.initials: G
authors.lastname: Liu
authors.forename: Sivashankar
authors.initials: S
authors.lastname: Subramaniam
authors.forename: Thomas Aloysius Kah Wai
authors.initials: TA
authors.lastname: Wong
authors.forename: Naresh
authors.initials: N
authors.lastname: Kumar
mesh_terms: D000368:Aged; D001241:Aspirin / Q000009:adverse effects*; D000077144:Clopidogrel; D019299:Decompression, Surgical; D005260:Female; D046748:Hematoma, Epidural, Spinal / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D013123:Spinal Fusion; D013988:Ticlopidine / Q000009:adverse effects* / Q000031:analogs & derivatives*
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin