dorsal spinal chronic subdural hematoma complicating warfarin/asprin anticoagulation therapy: a case report study.

Background Data: Spinal chronic subdural hematoma is an extremely rare condition nevertheless it can results in a disastrous neurological status.Purpose: To report a case of dorsal chronic subdural hematoma with acute paraplegia. Study Design: Case report. Methods: Our 61-year-old female patient presented with a one day history of sudden onset of motor weakness in both lower limbs. The patient had previous cerebrovascular ischemic attack two year earlier and combined aspirin (150 mg per day) and warfarin (10 mg per day) therapy was prescribed as secondary prophylaxis since that time. Dorsal spine MRI was done and it revealed an extensive dorsal spinal chronic subdural hematoma. Bleeding tendency was corrected over 24 hours and then a dorsal laminectomy was performed from D3 level down to D7 with evacuation of the hematoma about 60 hours after the onset of symptoms. Results: The patient showed no significant post operative clinical improvement mostly due to delayed presentation and a concomitant intramedullary bleeding. Conclusion: Delayed management and concomitant intramedullary pathology affect deleteriously the outcome of chronic spinal subdural hematoma.(2012ESJ009)