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http://dx.doi.org/10.4070/kcj.2011.41.12.759

Spontaneous Spinal Epidural Hematomas Associated With Acute Myocardial Infarction Treatment  

Yang, Seung-Min (Department of Neurological Surgery, College of Medicine, Chung-Ang University)
Kang, Suk-Hyung (Department of Neurological Surgery, Chung-Ang University Graduate School)
Kim, Kyoung-Tae (Department of Neurosurgery, Kyungpook National University Hospital)
Park, Seung-Won (Department of Neurological Surgery, College of Medicine, Chung-Ang University)
Lee, Wang-Soo (Division of Cardiology, College of Medicine, Chung-Ang University)
Publication Information
Korean Circulation Journal / v.41, no.12, 2011 , pp. 759-762 More about this Journal
Abstract
Many studies have reported spontaneous spinal epidural hematoma (SSEH). Although most cases are idiopathic, several are associated with thrombolytic therapy or anticoagulants. We report a case of SSEH coincident with acute myocardial infarction (AMI), which caused serious neurological deficits. A 56 year old man presented with chest pain accompanied with back and neck pain, which was regarded as an atypical symptom of AMI. He was treated with nitroglycerin, aspirin, low molecular weight heparin, and clopidogrel. A spinal magnetic resonance image taken after paraplegia developed 3 days after the initial symptoms revealed an epidural hematoma at the cervical and thoracolumbar spine. Despite emergent decompressive surgery, paraplegia has not improved 7 months after surgery. A SSEH should be considered when patients complain of abrupt, strong, and non-traumatic back and neck pain, particularly if they have no spinal pain history.
Keywords
Acute myocardial infarction; Hematoma, epidural, spinal; Paraplegia; Thrombolytic therapy; Anticoagulants;
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