Low-molecular-weight heparins/platelet aggregation inhibitors
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Low-molecular-weight heparins/platelet aggregation inhibitors Spontaneous spinal subdural haematoma: case report
A 60-year-old woman developed a spontaneous spinal subdural haematoma following treatment with aspirin, clopidogrel, unspecified GPIIb IIIa antagonists and low-molecular-weight heparins. The woman presented to hospital with an oppressive, epigastric pain irradiating to the left arm, accompanied by sweating and respiratory distress. Electrocardiogram revealed ST depression in the left precordial leads; hence, she started receiving anticoagulant therapy with unspecified low molecular weight heparins alongside triple platelet anti-aggregation with aspirin [acetylsalicylic acid], clopidogrel and unspecified GPIIb IIIa antagonists [glycoprotein IIb/IIIa inhibitors; routes and dosages not stated]. However, 1 hour later, she developed sudden-onset dorsolumbar pain, accompanied by progressive difficulty moving both her lower limbs. Paraplegy developed within approximately 3 hours. Spinal MRI revealed a D9-L1 dorsal lesion, posterolateral to the spinal cord, slightly hyperintense in T1 and heterogeneous in T2, which was dislocating and compressing the spinal cord at that level. Subdural haematoma was suspected. The woman underwent urgent dorsal laminectomy at D9-D12, which revealed a large subdural haematoma after opening the dura mater. The haematoma was subsequently drained. The source of bleeding could not be identified. After the surgery, she did not exhibit any neurological improvement. She was discharged with paraplegy, low dorsal sensory level (D10) and no sphincter control. Varela-Rois P, et al. Spontaneous spinal subdural hematoma. Revista de Neurologia 48: 156-158, No. 3, Feb 2009. Available from: URL: http://doi.org/10.33588/ rn.4803.2008427 [Spanish; summarised from a translation]
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Reactions 28 Nov 2020 No. 1832
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