Rivaroxaban
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Paraplegia due to spontaneous spinal hemorrhage: case report An 82-year-old woman developed paraplegia due to spontaneous spinal hemorrhage during treatment with rivaroxaban for stroke prevention. The woman presented with acute-onset back pain. Her lab tests showed elevated creatinine serum level. She had a history of persistent ischemic stroke, atrial fibrillation, myocardial infarction and coronary artery bypass graft. She had been receiving rivaroxaban 20 mg/day [route not stated] for stroke prevention along with other medications. On admission, she reported back pain, transient left lower extremity paresthesia, abdominal discomfort and an episode of vomiting a few hours prior to the admission. At admission, physical examination showed moderate dehydration along with completely irregular heart rate. Lab tests showed haemoglobin level of 6.6 mmol/L, RBC of 3.43 trillion cells/L and C-reactive protein 1.23 mg/dL. She suspected to exacerbation of chronic kidney disease due to dehydration. She was treated with tramadol and fluid resuscitation. On the second day of admission, she experienced muscle weakness in both lower limbs. Physical examination showed muscular strength of the right lower limb to be 0/5 and left lower limb 1/5 and mild hyperalgesia. Lab tests showed transient increase in C-reactive protein to 45 mg/dL. An MRI scan showed acute epidural hemorrhage in her thoracic and lumbar spine. She was finally diagnosed with paraplegia due to spontaneous spinal hemorrhage. She was referred to the neurology department of another hospital for further treatment and rehabilitation. At last follow-up with her family, no improvement in her motor function was achieved. Feret WB, et al. Paraplegia caused by spontaneous spinal hemorrhage in a patient undergoing rivaroxaban therapy. American Journal of Case Reports 21: 1-5, Jan 2020. 803501466 Available from: URL: http://doi.org/10.12659/AJCR.923607
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Reactions 19 Sep 2020 No. 1822
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