Spontaneous chronic epidural hematoma in the lumbar spine associated with Warfarin intake: a case report.
BACKGROUND
Spontaneous spinal epidural hematomas are rare. However, in patients on anticoagulant treatment the risk may increase. Symptomatically patients may present with radiculopathy and even progressive neurological deficits.


METHODS
We present a case of a warfarin treated patient with left L5 radiculopathy. MRI was evaluated as showing a lumbar disc prolapse or synovial cyst at L4-L5 level. The patient was operated and an organized material was removed and analysed as a hematoma. No prolapsed disc or synovial cyst was found. The patient was neurologically restored following the operation.


RESULTS
This case illustrates how spontaneous epidural spinal hematomas can present with symptoms of radiculopathy and radiologically be misinterpreted as a protruding disc or cyst.


CONCLUSIONS
Warfarin treated patients may have an increased risk of spontaneous spinal epidural hematomas.
Division of Neurosurgery and Clinical Neurophysiology, Department of Pharmacology and Clinical Neurosciences, Umeå University Hospital, Umeå, Sweden ; Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
Axel
A
Sandvig
Spinal Unit, Department of Ortopedics, Umeå University Hospital, Umeå, Sweden ; Spinal Unit, Department of Ortopedics, Uppsala University Hospital, Uppsala, Sweden.
Håkan
H
Jonsson
Anticoagulant treatment; L5-root compression; MRI; Radiculating pain