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Spontaneous spinal epidural hematoma: An urgent complication of adding clopidogrel to aspirin therapy

Authors
Moon, Hong-JooKim, Joo HanKim, Jong-HyunKwon, Taek-HyunChung, Hung-SeobPark, Youn-Kwan
Issue Date
15-10월-2009
Publisher
ELSEVIER SCIENCE BV
Keywords
Spontaneous spinal epidural hematoma; Clopidogrel; Aspirin; MATCH study
Citation
JOURNAL OF THE NEUROLOGICAL SCIENCES, v.285, no.1-2, pp.254 - 256
Indexed
SCIE
SCOPUS
Journal Title
JOURNAL OF THE NEUROLOGICAL SCIENCES
Volume
285
Number
1-2
Start Page
254
End Page
256
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/119105
DOI
10.1016/j.jns.2009.06.028
ISSN
0022-510X
Abstract
We report a 56-year-old patient who had been taking anti hypertensive medication in combination with prophylactic aspirin for 19 years who was diagnosed with stable angina with significant coronary artery stenosis on angiography. He was treated with drug-eluting coronary stent placement. Clopidogrel was added to the previous treatment regimen after stent placement. He visited the emergency room with complaints of severe back pain accompanied by radiculopathy and left leg weakness. The patient had an excellent outcome after immediate diagnosis by MRI and emergent evacuation of spontaneous spinal epidural hematoma (SSEH). The present case is interesting because it is the first case in spine which corresponds to the findings of MATCH study that bleeding tendency would be raised by dual antiplatelet treatment (aspirin + clopidogrel). With the popularity of antiplatelet medications, physicians should be aware of this critical side effect and provide urgent treatment. Furthermore, we should be cautious when we prescribe clopidogrel in addition to aspirin because it could cause bleeding complications like SSEH. (c) 2009 Elsevier B.V. All rights reserved.
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