Spinal Epidural Hematoma during Anticoagulant Therapy

Abstract

Spinal epidural hematoma complicated the course of anticoagulant therapy of cerebrovascular disease in a patient in whom observations of multiple aspects of coagulation had been obtained. Examination of this case and a review of the literature allow delineation of a syndrome that should aid in early diagnosis of spinal epidural hematoma. It is clear that coumarin derivatives induce multiple coagulation defects, which vary quantitatively and qualitatively with time. Contemporary evaluation of the benefits and risks of long-term anticoagulants is beset by many problems that have not been fully resolved.