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Case Reports
. 2017 Mar 22;12(2):257-260.
doi: 10.1016/j.radcr.2017.02.004. eCollection 2017 Jun.

Spinal subarachnoid and subdural hematoma presenting as a Brown-Séquard-like myelopathy following minor trauma in a patient on dabigatran etexilate

Allen R Wolfe  1 , Raihan M Faroqui  2 , George A Visvikis  1 , Michael T Mantello  1 , Allan B Perel  3 , Sanjit O Tewari  1
Affiliations
Case Reports

Spinal subarachnoid and subdural hematoma presenting as a Brown-Séquard-like myelopathy following minor trauma in a patient on dabigatran etexilate

Allen R Wolfe et al. Radiol Case Rep. .

Abstract

Dabigatran etexilate is a relatively new anticoagulant from the class of direct thrombin inhibitors which is administered orally and does not require routine blood work monitoring. Dabigatran may be attractive to both clinicians and patients because of both its convenience and efficacy; however, clinical complications are still being elucidated. Here, we present a previously unreported case of spinal subarachnoid and subdural hematoma presenting as a Brown-Séquard-like myelopathy in a patient after minor trauma in the setting of Dabigatran anticoagulation.

Keywords: Brown-Séquard syndrome; Dabigatran etexilate; Extraaxial; Hematoma; Trauma.

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Figures

Fig. 1
Fig. 1
Axial CT image (A) demonstrates high-density material surrounding the cervical spine (red arrows), suspicious for subarachnoid hematoma. Two consecutive MR axial T2-weighted images (B and C) at the C6/C7 level demonstrate hypointense crescent-shaped signal (red arrows) compressing the cord posterolaterally (green arrows), consistent with subdural hematoma. GRE sequences of the lesion (D) show mixed signal intensity (blue arrow) with a hypointense rim (yellow arrows), indicating an early subacute hemorrhage with surrounding hemosiderin. CT, computed tomography; GRE, gradient echo.
See this image and copyright information in PMC

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