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Intraspinal hemorrhage is a rare but dangerous complication of anticoagulant therapy. It must be suspected in any patient taking anticoagulant agents who complains of local or referred spinal pain associated with limb weakness, sensory defi cits, or urinary retention. We describe a patient with hematomyelia, review the literature on hematomyelia and other intraspinal hemorrhage syndromes, and summarize intraspinal hemorrhage associated with oral anticoagulant therapy. The patient (a 62-yea r-old man) resembled previously described patients with hematomyelia in age and sex. However, he was unusual in having cervical rather than thoracic localization. As with intracranial bleeding, the incidence of intraspinal hemorrhage associated with ant icoagulant therapy might be minimized by close monitory and tight control of the intensity of anticoagulation. However, it is noteworthy that many of the reported cases were anticoagulated in the therapeutic range. If intraspinal hemorrhage is suspected , anticoagulation must be reversed immediately. Emergency laminectomy and decompression of the spinal cord appear mandatory if permanent neurologic sequelae are to be minimized. A high index of suspicion, prompt recognition, and immediate intervention a re essential to prevent major morbidity and mortality from intraspinal hemorrhage. |
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anticoagulant,complications of
anticoagulant,reversal of
anticoagulant,treatment
Brown Sequard syndrome
coumarin
emergencies,neurologic
hematomyelia
iatrogenic neurologic disorders
laminectomy
neck pain
spinal cord,cervical
treatment of neurologic disorder
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