Abstract | BACKGROUND CONTEXT: PURPOSE: STUDY DESIGN: Clinical case report. METHODS: A 65-year-old man presented with weakness of upper and lower limbs with bowel and bladder dysfunction after LMWH therapy for an acute coronary syndrome. Magnetic resonance imaging (MRI) revealed an anterior cervical EDH extending from C4 to T1 with significant cord compression. Associated comorbidities precluded emergent surgical intervention, and the patient was managed conservatively with cessation of LMWH therapy. RESULTS: The patient showed signs of early neurological recovery within 24 hours (ASIA C [American Spinal Injury Association] to ASIA D) of cessation of LMWH, and hence surgery was deferred. Complete motor and sensory recovery was observed at 1-month follow up with resolution of the cervical EDH without any cord compression evident on the MRI. CONCLUSIONS:
LMWH therapy is an important cause of SSH leading to significant neurological deficits. Conservative management is a viable treatment option in patients who demonstrate early and sustained neurological recovery with the cessation of LMWH therapy.
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Authors | M Subbiah, Ashwin Avadhani, Ajoy Prasad Shetty, S Rajasekaran |
Journal | The spine journal : official journal of the North American Spine Society
(Spine J)
Vol. 10
Issue 7
Pg. e11-5
(Jul 2010)
ISSN: 1878-1632 [Electronic] United States |
PMID | 20547109
(Publication Type: Case Reports, Journal Article)
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Copyright | Copyright 2010 Elsevier Inc. All rights reserved. |
Chemical References |
- Anticoagulants
- Heparin, Low-Molecular-Weight
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Topics |
- Aged
- Anticoagulants
(adverse effects)
- Cervical Vertebrae
(pathology)
- Hematoma, Epidural, Spinal
(chemically induced, complications, therapy)
- Heparin, Low-Molecular-Weight
(adverse effects)
- Humans
- Male
- Paresis
(etiology, therapy)
- Spinal Cord Compression
(complications, therapy)
- Urinary Bladder, Neurogenic
(complications, pathology)
- Withholding Treatment
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