Spontaneous spinal subdural haematoma in a patient on apixaban

BMJ Case Rep. 2019 Jan 22;12(1):e227311. doi: 10.1136/bcr-2018-227311.

Abstract

A 68-year-old man on apixaban presented to the emergency department with back pain following a long-haul flight. Investigations for pulmonary embolus and aortic dissection were negative and he was discharged with analgesia for mechanical back pain. He presented three more times with worsening back pain, third time with urinary retention and the fourth time with lower limb weakness and loss of coordination. He was found to have a spinal subdural haematoma on MRI and transferred to a tertiary centre, where he was managed conservatively and discharged for rehabilitation with good neurological recovery.

Keywords: back pain; neurological injury; neurology; neurosurgery; spinal cord.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Ataxia / etiology
  • Back Pain / diagnosis
  • Back Pain / etiology*
  • Conservative Treatment
  • Diagnosis, Differential
  • Factor Xa Inhibitors / adverse effects
  • Hematoma, Subdural, Spinal / chemically induced*
  • Hematoma, Subdural, Spinal / diagnostic imaging*
  • Hematoma, Subdural, Spinal / rehabilitation
  • Humans
  • Iatrogenic Disease / epidemiology
  • Magnetic Resonance Imaging / methods
  • Male
  • Pyrazoles / adverse effects*
  • Pyridones / adverse effects*
  • Treatment Outcome
  • Urinary Retention / etiology

Substances

  • Factor Xa Inhibitors
  • Pyrazoles
  • Pyridones
  • apixaban