Skip to main content
Log in

Relapsed spontaneous spinal epidural hematoma associated with aspirin and clopidogrel

  • Case Report
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

An acute spontaneous spinal epidural hematoma (SSEH) is a rare spinal pathology. A 57-year-old man who had hypertension and had been on dual antiplatelet therapy with aspirin and clopidogrel for primary prevention presented with the sudden onset of mid back pain and monoplegia of the left lower extremity. Magnetic resonance imaging revealed an epidural hematoma, and the patient underwent emergency hemilaminectomy for evacuation. However, the symptoms worsened, and complete paraplegia developed. A second procedure to remove the recurrent hematoma was performed. No vascular malformation or other possible cause for SSEH was found other than the aspirin and clopidogrel medication. This case report describes relapsed SSEH caused by the combination of aspirin and clopidogrel medication and urges caution in prescribing dual antiplatelet agents.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Pullarkat VA, Kalapura T, Pincus M, Baskharoun R (2000) Intraspinal hemorrhage complicating oral anticoagulant therapy: an unusual case of cervical hematomyelia and a review of the literature. Arch Intern Med 160:237–240

    Article  PubMed  CAS  Google Scholar 

  2. Finsterer J, Seywald S, Stollberger C et al (2008) Recovery from acute paraplegia due to spontaneous spinal, epidural hematoma under minimal-dose acetyl-salicylic acid. Neurol Sci 29:271–273

    Article  PubMed  Google Scholar 

  3. Moon HJ, Kim JH, Kwon TH, Chung HS, Park YK (2009) Spontaneous spinal epidural hematoma: an urgent complication of adding clopidogrel to aspirin therapy. J Neurol Sci 285:254–256

    Article  PubMed  CAS  Google Scholar 

  4. Second Chinese Cardiac Study (CCS-2) Collaborative Group (2000) Rationale, design and organization of the Second Chinese Cardiac Study (CCS-2) a randomized trial of clopidogrel plus aspirin, and of metoprolol, among patients with suspected acute myocardial infarction. Second Chinese Cardiac Study (CCS-2) Collaborative Group. J Cardiovasc Risk 7:435–441

    Google Scholar 

  5. Antithrombotic Trialists’ Collaboration (2002) Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 324:71–86

    Google Scholar 

  6. Yusuf S, Zhao F, Mehta SR, Chrolavicius S, Tognoni G, Fox KK (2001) Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 345:494–502

    Article  PubMed  CAS  Google Scholar 

  7. Hentschel SJ, Woolfenden AR, Fairholm DJ (2001) Resolution of spontaneous spinal epidural hematoma without surgery: report of two cases. Spine (Phila Pa 1976) 26:E525–E527

    Article  CAS  Google Scholar 

  8. Kreppel D, Antoniadis G, Seeling W (2003) Spinal hematoma: a literature survey with meta-analysis of 613 patients. Neurosurg Rev 26:1–49

    Article  PubMed  CAS  Google Scholar 

  9. McQuarrie IG (1978) Recovery from paraplegia caused by spontaneous spinal epidural hematoma. Neurology 28:224–228

    PubMed  CAS  Google Scholar 

  10. Sanossian N, Saver JL, Rajajee V et al (2006) Premorbid antiplatelet use and ischemic stroke outcomes. Neurology 66:319–323

    Article  PubMed  CAS  Google Scholar 

  11. Chen ZM, Jiang LX, Chen YP et al (2005) Addition of clopidogrel to aspirin in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet 366:1607–1621

    Article  PubMed  CAS  Google Scholar 

  12. Diener HC, Bogousslavsky J, Brass LM et al (2004) Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo-controlled trial. Lancet 364:331–337

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors(s) or upon any organization with which the author(s) is/are associated.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Young Jin Ko.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lim, S.H., Hong, B.Y., Cho, Y.R. et al. Relapsed spontaneous spinal epidural hematoma associated with aspirin and clopidogrel. Neurol Sci 32, 687–689 (2011). https://doi.org/10.1007/s10072-011-0508-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-011-0508-5

Keywords

Navigation