Spontaneous spinal epidural hematoma due to Clopidogrel: A case study and review of literature

4^th Global Congress on Spine and Spinal Disorders

September 05-06, 2018 Auckland, New Zealand

Aashish Ghodke

Department of Orthopaedics, India

Scientific Tracks Abstracts: J Spine

Abstract :

Introduction & Aim: Cases of spinal epidural hematoma without trauma or other mechanical insult are defined as Spontaneous Spinal Epidural Hematoma (SSEH). SSEH is an uncommon neurological emergency which can present with the features ranging from simple back pain with radiculopathy to complete paraplegia or quadriplegia depending on the site and severity of the compression. SSEH associated with anti-platelet drugs is rarely seen and there are less than 10 cases of clopidogrel induced SSEH being reported in the literature. We hereby, report a case of clopidogrel induced SSEH and discuss what literature has to say on anticoagulant induced SSEH. Method: We report a case of SSEH in a 76-year-old hypertensive female who was on Clopidogrel post angioplasty done 1 year back and presented with sudden onset paraplegia preceded by severe back pain. MRI was done which revealed a space occupying lesion at D9-D10 level, suggestive of an epidural hematoma. Emergent decompressive laminectomy was done within eight hours of the presentation with excellent clinical outcome. Result: Patient underwent emergency decompressive laminectomy from D9-D11 level and evacuation of an extradural space occupying lesion, which was later histologically proven to be a hematoma. After surgery there was a significant sensory recovery, one week after surgery her weakness improved with muscle power of hip and knee flexors was 3/5 and one month postoperatively, she could walk without any assistance. Conclusion: SSEH is a rare neurosurgical emergency and with the growing trend of anti-platelet prescriptions for prophylactic use, clinicians should be aware of this serious complication especially when other risk factors like uncontrolled hypertension are present. Correct diagnosis and urgent decompressive surgery with evacuation of the hematoma is imperative for successful recovery if severe neurological deterioration is present.

Biography :

Aashish Ghodke is committed to highest standard of excellence at Department of Orthopaedics, India. He has worked for more than 10 years in the related field and gained a plethora of knowledge in related field. His international experience includes various programs, contributions to reputed journals and participation in different international conferences in diverse fields of study.

E-mail: aashishghodke@gmail.com