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Warfarin-associated Hematomyelia
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- Famularo Giuseppe
- Department of Internal Medicine, San Camillo Hospital, Italy
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- Sajeva Maria Rosaria
- Department of Internal Medicine, San Camillo Hospital, Italy
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- Gasbarrone Laura
- Department of Internal Medicine, San Camillo Hospital, Italy
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Description
A 71-year-old woman on warfarin (2.5 mg daily) developed severe low back pain with reduced touch sensation and weakness of the lower limbs that progressed to complete paralysis within 28 to 30 hours. Imaging revealed bleeding at the D4 through D11 level, however the patient refused emergency laminectomy. No recovery was observed and the patient was discharged to a rehabilitation facility. Only few other cases of hematomyelia linked to anticoagulant therapy have been reported. Early diagnosis, appropriate management and immediate intervention are needed to prevent irreversible neurological sequelae. The elusive clinical features at presentation may cause an important diagnostic delay.<br>
Journal
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- Internal Medicine
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Internal Medicine 53 (6), 623-626, 2014
The Japanese Society of Internal Medicine
