title: Spontaneous epidural hematoma of the spine associated with oral anticoagulants: 3 Case Studies.
abstract: BACKGROUND
  Spontaneous epidural hematoma of the spine (SEHS) is an extremely rare entity. Patients known to have thrombophilia or on anticoagulant drugs are the most affected. It is generally caused by a rupture of the postero-internal vertebral venous plexus secondary to minor barotrauma such as cough, peridural catheter insertion... Early diagnosis and treatment showed to have the best outcome.
  
  
  METHODS
  We report 3 cases of spontaneous epidural hematoma in patients treated by acenocoumarol, which occurred without any provocative factor. All 3 patients were treated with decompressive laminectomy.
  
  
  CONCLUSIONS
  We described the MRI findings and discussed the spontaneity of the entity. Our present case studies and the review of the literature showed that early diagnosis and management of SEHS can lead to improvement of the neurological state and avoid definitive motor and sensitive deficit.
  
  
  CONCLUSIONS
  This rare entity should be suspected in every acute medullary syndrome with spinal pain, motor and/or sensory deficit. In order to decrease the sequelae, neurologically unstable patients should benefit from early diagnosis and urgent surgical decompression.
authors.affiliation: PGY4 Orthopedic Surgery, Holy Spirit University of Kaslik - CHU Notre Dame de Secours, Jbeil, Lebanon. Electronic address: charbeltauk@hotmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Tawk
authors.affiliation: PGY1 Orthopedic Surgery, Holy Spirit University of Kaslik-CHU Notre Dames de Secours, Jbeil, Lebanon.
authors.forename: M
authors.initials: M
authors.lastname: El Hajj Moussa
authors.affiliation: PGY4 Radiology, Holy Spirit University of Kaslik - CHU Notre Dame de Secours, Jbeil, Lebanon.
authors.forename: R
authors.initials: R
authors.lastname: Zgheib
authors.affiliation: Internal medicine, Ass. Professor Holy Spirit University of Kaslik - CHU Notre Dame de Secours, Jbeil, Lebanon.
authors.forename: G
authors.initials: G
authors.lastname: Nohra
keywords: Acenocoumarol; Oral anticoagulants; Spontaneous epidural hematoma of the spine