title: Warfarin-associated hematomyelia.
abstract: A 71-year-old woman on warfarin (2.5 mg daily) developed severe low back pain with reduced touch sensation and weakness of the lower limbs that progressed to complete paralysis within 28 to 30 hours. Imaging revealed bleeding at the D4 through D11 level, however the patient refused emergency laminectomy. No recovery was observed and the patient was discharged to a rehabilitation facility. Only few other cases of hematomyelia linked to anticoagulant therapy have been reported. Early diagnosis, appropriate management and immediate intervention are needed to prevent irreversible neurological sequelae. The elusive clinical features at presentation may cause an important diagnostic delay.
authors.affiliation: Department of Internal Medicine, San Camillo Hospital, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Famularo
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Sajeva
authors.forename: Laura
authors.initials: L
authors.lastname: Gasbarrone
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology; D010243:Paralysis / Q000209:etiology* / Q000534:rehabilitation; D010949:Plasma; D020758:Spinal Cord Vascular Diseases / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis*; D014812:Vitamin K / Q000627:therapeutic use; D014859:Warfarin / Q000009:adverse effects*
chemical_list: D000925:Anticoagulants; D000933:Antifibrinolytic Agents; D014812:Vitamin K; D014859:Warfarin