hematoma subdural de medula espinhal associada ao uso de anticoagulante oral hematoma subdural de la médula espinal asociado al uso de anticoagulante oral spine subdural hematoma: a rare complication associated with vitamin k antagonist (vka)
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Abstract
El hematoma subdural espinal (HSE) es una complicación rara proveniente del uso de antagonistas de vitamina K (AVK) y de diagnostico difícil. Este artículo presenta un caso con complicación amenazadora para la vida: un paciente octogenario portador de fibrilación auricular de inicio reciente, en uso de AVK. Inicialmente, la historia y el examen físico se presentaban normales, asociados a la elevación de los valores de coagulograma supra terapéuticos (INR > 10). Tras 24 horas del ingreso hospitalario, el paciente presentó tetraparesia progresiva. Al realizarse una resonancia nuclear magnética (RNM) de médula espinal, se evidenció un HSE (Figura 1). Tras reversión completa de la hipocoagulación e intervención neuroquirúrgica el paciente obtuvo mejora del cuadro neurológico.
Spinal subdural hematoma (SSDH) is a rare condition, which is difficult to diagnose, related to Vitamin K Antagonist. This a case report of a life-threatening situation in a octogenarian patient with a history of recent atrial fibrillation that received K-Vitamin Antagonist (KVA) therapy. The history and the clinical assessment were normal at the admission, associated with increase in the coagulation parameters (INR >10). Twenty-four hours after the admission, the patient developed progressive tetraparesis and a Magnetic Resonance Imaging (MRI) was performed, disclosing the evidence of a SSDH (Figure 1). An emergency neurosurgical intervention was performed associated with normalization of the coagulation parameters. After the procedure, the patient presented improvement of the neurological symptoms.
| Reference Key |
flato2009arquivoshematoma
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|---|---|
| Authors | ;Uri Adrian Prync Flato;Paulo Sérgio Rheder;Helio Penna Guimarães;Elias Silva Flato;Paulo Cretella |
| Journal | revista cubana de ciencias informáticas |
| Year | 2009 |
| DOI |
10.1590/S0066-782X2009000100013
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| URL | |
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