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Case Reports
. 2007 Jun;22(3):577-9.
doi: 10.3346/jkms.2007.22.3.577.

Clopidogrel-induced spontaneous spinal epidural hematoma

Jae Hoon Sung  1 , Jae Taek Hong, Byung Chul Son, Sang Won Lee
Affiliations
Case Reports

Clopidogrel-induced spontaneous spinal epidural hematoma

Jae Hoon Sung et al. J Korean Med Sci. 2007 Jun.

Abstract

The hemorrhagic side effects associated with the use of clopidogrel are within the acceptable range and occur mainly at skin or gastrointestinal sites. We report a case of spontaneous spinal epidural hematoma (SSEH) in a 60-yr-old woman who was treated with clopidogrel for frequent transient ischemic attacks. To our knowledge, this is the second reported case of clopidogrel-induced SSEH. The patient's symptoms and past history of clopidogrel use suggested the diagnosis and made the procedure proceed quickly to operate SSEH 9 hr after the onset of paraplegia. The outcome was excellent. Therefore, with the popularity of antiplatelet prescription, physicians should keep in mind and urgently treat this unusual but critical side effect.

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Conflict of interest statement

There are no conflicts of interests or research grant funding.

Figures

Fig. 1
Fig. 1
Initial brain magnetic resonance (MR) imaging shows small lacunar infarction at the left upper pons (A) and both posterior thalami (B). Brain MR angiography shows no definite extra or intracranial vessel occlusion or stenosis (C).
Fig. 2
Fig. 2
Thoracic sagittal magnetic resonance imaging shows a large elliptical epidural mass that is iso- to hypersignal on T1 (A) and cerebrospinal fluid-like hypersignal on T2-weighted images (B). It is compatible with an acute epidural hematoma with marked cord compression. Postoperative T2-weighted image (C) shows a thoracic laminectomy defect with complete removal of the hematoma and restoration of cord contour.
See this image and copyright information in PMC

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