Spinal Subdural Hematoma in a Young Adult with Hemophilia A: A Case Report
Clinical Medicine Research
Volume 9, Issue 3, May 2020, Pages: 65-68
Received: May 22, 2020; Accepted: Jun. 12, 2020; Published: Jun. 20, 2020
Views 36      Downloads 28
Authors
Chunjiang Yan, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China; Department of Emergency Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
Ye Ye, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China; Department of Emergency Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China; Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou, China
Ruifeng Zeng, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China; Department of Emergency Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
Xiaoxin Wu, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China; Department of Emergency Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
Guorong Liang, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China; Department of Emergency Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
Huanmei Li, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China; Department of Emergency Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
Article Tools
Follow on us
Abstract
Hemophilia is a set of hereditary hemorrhagic disorders of coagulation-dysfunction that can cause repeated bleeding in various tissues and organs. And the patient can be disabled due to bleeding from bones, joints, and soft tissue, or die due to splenic rupture or intracranial bleeding. So it is crucial to detect the site of bleeding in hemophilia patients quickly. Spontaneous spinal canal hematoma is a rare complication of hemophilia, with less than 50 cases reported to date. It can be easily missed and cause serious harm to patients. Hematoma, if untreated, causes irreversible nerve damage by compression of the spinal cord. Early recognition and treatment are most useful to prevent spontaneous spinal canal hematoma. We describe the case of a 21-year-old man with severe lumbago for two days, who had hemophilia A for a decade. The patient was diagnosed with spinal subdural hematoma by magnetic resonance imaging (MRI) after ruling out other causes of lumbago and treated with drugs by a neurologist. The hematoma showed absorption by MRI after six months. In conclusion, spontaneous spinal canal hematoma is a severe complication of hemophilia, which is often missed. This successful case confirms the importance of early diagnosis and treatment of spontaneous spinal canal hematoma. We hope to increase the clinicians’ vigilance of this disease.
Keywords
Hemophilia, Spinal Subdural Hematoma, MRI, Rare Case, Case Report
To cite this article
Chunjiang Yan, Ye Ye, Ruifeng Zeng, Xiaoxin Wu, Guorong Liang, Huanmei Li, Spinal Subdural Hematoma in a Young Adult with Hemophilia A: A Case Report, Clinical Medicine Research. Vol. 9, No. 3, 2020, pp. 65-68. doi: 10.11648/j.cmr.20200903.14
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
Lillemäe K, Järviö JA, Silvasti-Lundell MK, Antinheimo JJ, Hernesniemi JA, Niemi TT. Incidence of Postoperative Hematomas Requiring Surgical Treatment in Neurosurgery: A Retrospective Observational Study. World Neurosurg. 2017; 108: 491-497.
[2]
Lawton MT, Porter RW, Heiserman JE, Jacobowitz R, Sonntag VK, Dickman CA. Surgical management of spinal epidural hematoma: relationship between surgical timing and neurological outcome. J Neurosurg 1995; 83: 1-7.
[3]
Groen RJ, Van Alphen HA. Operative treatment of spontaneous spinal epidural hematomas: a study of the factors determining postoperative outcome. Neurosurgery 1996, 39: 494-508; discussion 508-499.
[4]
Huang. G. F, Liu. D. H. Epidural hematoma of spinal cord. Foreign Medical Sciences Section on Neurology & Neurosurgery 1996; 23: 169-172.
[5]
Friday RY, Pollack IF, Bowen A, Pollack A, Ragni M. Spontaneous spinal subdural hematoma in a young adult with hemophilia. J Natl Med Assoc 1999; 91: 289-294.
[6]
Cabrera Manchola A, Manchola I, Larena JA, Martinez de Guerenu B, Casado O. Follow up of a spontaneous ventral subarachnoid spinal haematoma by means of magnetic resonance. Rev Neurol 2001; 32: 1137-1140.
[7]
Holtas S, Heiling M, Lonntoft M. Spontaneous spinal epidural hematoma: findings at MR imaging and clinical correlation. Radiology 1996; 199: 409-413.
[8]
Oldenkott P, Preger R, Todorow S. Spinal epidural hematoma and anticoagulation treatment. Med Welt 1981; 32: 46-49.
[9]
Domenicucci M, Ramieri A, Ciappetta P, Delfini R. Nontraumatic acute spinal subdural hematoma: report of five cases and review of the literature. J Neurosurg 1999; 91: 65-7.
[10]
Park JH, Park S, Choi SA. Incidence and risk factors of spinal epidural hemorrhage after spine surgery: a cross-sectional retrospective analysis of a national database. BMC Musculoskelet Disord. 2020; 21 (1): 324.
[11]
Kobayashi K, Ando K, Nishida Y, Ishiguro N, Imagama S. Epidemiological trends in spine surgery over 10 years in a multicenter database. Eur Spine J. 2018; 27 (8): 1698-1703.
[12]
Oichi Y, Toda H, Yamagishi K, Tsujimoto Y. Multiple Spinal Chronic Subdural Hematomas Associated with Thoracic Hematomyelia: A Case Report and Literature Review. World Neurosurg. 2019; 131: 95-103.
[13]
Masuda S, Fujibayashi S, Takemoto M, et al. Incidence and Clinical Features of Postoperative Symptomatic Hematoma after Spine Surgery: A Multicenter Study of 45 Patients. Spine Surg Relat Res. 2019; 4 (2): 130-134.
[14]
Tavolaro C, Ghaffar S, Zhou H, Nguyen QT, Bellabarba C, Bransford RJ. Is routine MRI of the spine necessary in trauma patients with ankylosing spinal disorders or is a CT scan sufficient? Spine J. 2019; 19 (8): 1331-1339.
[15]
Lagerkranser M, Lindquist C. Neuraxial blocks and spinal haematoma: Review of 166 cases published 1994 - 2015. Part 2: diagnosis, treatment, and outcome. Scand J Pain. 2017; 15: 130-136.
[16]
Maddali P, Walker B, Fisahn C, et al. Subdural Thoracolumbar Spine Hematoma after Spinal Anesthesia: A Rare Occurrence and Literature Review of Spinal Hematomas after Spinal Anesthesia. Cureus. 2017; 9 (2): e1032.
[17]
Hegde A, Nair R, Upadhyaya S. Spontaneous intracerebral hemorrhage in hemophiliacs-A treatment dilemma. Int J Surg Case Rep. 2016; 29: 17-19.
[18]
Shalabi A, Kachel E, Kogan A, et al. Cardiac surgery in patients with Hemophilia: is it safe?. J Cardiothorac Surg. 2020; 15 (1): 76.
ADDRESS
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
U.S.A.
Tel: (001)347-983-5186