Epidural Hematoma Related with Low-Dose Aspirin : Complete Recovery without Surgical Treatment

Abstract

Hemorrhagic complications associated with aspirin use occur primarily at skin or gastrointestinal sites but can occasionally occur in the central nervous system. In particular, spontaneous spinal epidural hemorrhage (SSEH) associated with aspirin is very rare. We report a case of low-dose (100 mg daily) aspirin-related SSEH that was successfully treated with medical management. Our case indicates that low-dose aspirin could induce SSEH and that conservative treatment with close observation and repeated imaging studies should be considered in cases with neurological improvement or mild deficits.

Keywords: Aspirin; Medical management; Spinal epidural hematoma.

Fig. 1

Initial and follow-up imaging studies. A : Initial cervical CT shows a high density mass in the dorsal portion of the epidural space from C3 to C5. B : Initial T2 sagittal cervical MRI shows a huge mass in the dorsal portion of the epidural space from C3 to C5 with cord compression. C : Twenty-four hour follow-up CT shows a partial decrease of the hematoma. D : Seven day follow-up MRI (T2 sagittal image) shows complete resolution of the epidural hematoma.