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. 2016 Oct 21;5(1):1832.
doi: 10.1186/s40064-016-3546-x. eCollection 2016.

Spontaneous chronic epidural hematoma in the lumbar spine associated with Warfarin intake: a case report

Axel Sandvig  1 , Håkan Jonsson  2
Affiliations

Spontaneous chronic epidural hematoma in the lumbar spine associated with Warfarin intake: a case report

Axel Sandvig et al. Springerplus. .

Abstract

Introduction: Spontaneous spinal epidural hematomas are rare. However, in patients on anticoagulant treatment the risk may increase. Symptomatically patients may present with radiculopathy and even progressive neurological deficits.

Case description: We present a case of a warfarin treated patient with left L5 radiculopathy. MRI was evaluated as showing a lumbar disc prolapse or synovial cyst at L4-L5 level. The patient was operated and an organized material was removed and analysed as a hematoma. No prolapsed disc or synovial cyst was found. The patient was neurologically restored following the operation.

Discussion and evaluation: This case illustrates how spontaneous epidural spinal hematomas can present with symptoms of radiculopathy and radiologically be misinterpreted as a protruding disc or cyst.

Conclusion: Warfarin treated patients may have an increased risk of spontaneous spinal epidural hematomas.

Keywords: Anticoagulant treatment; L5-root compression; MRI; Radiculating pain.

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Figures

Fig. 1
Fig. 1
Sagital T1-weighted (a) and T2-weighted (b) axial T1-weighted image (c) and axial T2-weighted image (d) demonstrating a high signal intense epidural hematoma on the left side lumbar level L4–L5 and compressing the left L5-root
Fig. 2
Fig. 2
a Histopathological specimen of organised epidural hematoma and b higher magnification of boxed area in a
See this image and copyright information in PMC

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