Spontaneous spinal hematomas and low-molecular-weight heparin. Report of four cases and review of the literature

Journal of Neurosurgery. Spine
Peter A HeppnerAndrew J J Law

Abstract

The purpose of this article is to raise awareness of spontaneous spinal hematomas that develop after administration of low-molecular-weight heparin therapy. The authors describe four patients in whom these hematomas developed without precipitating events while receiving a treatment dose of enoxaparin (Clexane) (approximately 1 mg/kg). Spontaneous spinal hematomas (not related to trauma, surgery, or lumbar puncture) are a rare clinical entity. Several causes have been identified, including acquired and congenital clotting abnormalities and underlying vascular lesions. Aspirin, warfarin, tissue plasminogen activator, and heparin have all been implicated in causing spinal hematomas. Concerns regarding the use of low-molecular-weight heparin agents in neuraxis anesthesia have been well documented. Their possible contribution to nontraumatic spinal hematomas has been less well described. The authors believe that low-molecular-weight heparin agents present a small but significant risk of spinal hematoma. This should be considered when prescribing therapy because such a complication may be catastrophic.

References

May 11, 1978·The New England Journal of Medicine·J D Proctor
Jan 1, 1990·Biological cybernetics·R TomovićD Tepavac
Aug 1, 1987·Neurology·H MattleM Mumenthaler
Aug 8, 1968·The New England Journal of Medicine·H JickS Shapiro
Oct 1, 1995·Chest·M N LevineJ Hirsh
Aug 1, 1995·Journal of the American College of Cardiology·E P GurfinkelB Mautner
Oct 1, 1994·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·J HolstP B Ostergaard
Apr 22, 1996·Archives of Internal Medicine·N R CampbellG E Raskob
Jun 12, 1997·The New England Journal of Medicine·UNKNOWN EPILOG Investigators
Jun 13, 1998·The New England Journal of Medicine·D K WysowskiP Botstein
Feb 7, 2001·Chest·M N LevineC Kearon
Jul 3, 2002·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·S OlsonE Guazzo
Jul 10, 2002·Stroke; a Journal of Cerebral Circulation·Carl Counsell, Peter Sandercock

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Citations

Jul 29, 2009·Journal of the Neurological Sciences·Hong-Joo MoonYoun-Kwan Park
Jul 25, 2009·PM & R : the Journal of Injury, Function, and Rehabilitation·Douglas Elwood, Caroline Koo
Jan 22, 2009·Obstetrics and Gynecology·Evan ForsnesReinaldo Acosta
May 6, 2008·The Spine Journal : Official Journal of the North American Spine Society·Ruben Alejandro Morales CiancioPierre Guigui
Sep 23, 2008·Handbook of Clinical Neurology·Veronika I Skvortsova, Sara Z Bahar
Mar 29, 2008·Journal of Intensive Care Medicine·Stephanie Mallow Corbett, Jill A Rebuck
Sep 23, 2009·American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses·Rebecca Anne Dampeer
Aug 3, 2007·The Journal of Bone and Joint Surgery. American Volume·Christof BirkenmaierChristoph von Schulze Pellengahr
Dec 21, 2012·Journal of Orthopaedic Surgery·Lushun WangNaresh Kumar
Apr 16, 2018·Neurospine·Francesco Ciro TamburrelliLuca Proietti

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