Clopidogrel
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Spontaneous spinal epidural haematoma: case report A 60-year-old woman developed a spontaneous spinal epidural haematoma (SSEH) while receiving clopidogrel for transient ischaemic attacks. The woman had been receiving daily clopidogrel 75mg, following a diagnosis of multiple transient ischaemic attacks in September 2002. In July 2003, she experienced sudden severe back pain radiating to her chest, and subjective weakness in both legs, and was hospitalised. On neurological examination, she was found to have paraplegia and severe numbness below the D10 dermatome. MRI revealed a large elliptical mass occupying the posterior epidural space from T6 to T9, with compression and anterior displacement of the spinal cord. A diagnosis of SSEH was made. The women underwent an emergency laminectomy from T6 to T9, and complete evacuation of the haematoma was achieved. Antiplatelet medication was discontinued. The woman had recovered complete muscle strength at 3 months postoperatively. Author comment: "We cannot completely rule out the possibility of a coincidence of SSEH and the medical history of taking clopidogrel; however, considering its mechanism of action, the probability of a causal association would seem to be much higher." Sung JH, et al. Clopidogrel-induced spontaneous spinal epidural hematoma. Journal of Korean Medical Science 22: 577-579, No. 3, Jun 2007 - South 801090353 Korea
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Reactions 28 Jul 2007 No. 1162
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