Spinal epidural hematoma

Case contributed by Andrew Lawson
Diagnosis certain

Presentation

Acute paraplegia, warfarin usage

Patient Data

Age: 50 years
Gender: Male
mri

Extensive, acute epidural hematoma extending from C3 to T4 compressing the spinal cord. There is increased T2 signal within the cord, likely reflecting cord edema. 

mri

Post operative laminectomy demonstrates near complete evacuation with minimal blood product around the T3 level.

Case Discussion

Spontaneous epidural hemorrhage is an uncommon cause of spinal cord compression. There should be a higher index of suspicion in patients who are anticoagulated. 

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