Extensive spontaneous cervical epidural hematoma due to oral anticoagulant (dabigatran) successfully treated with reversal agent idarucizumab alone

Author:

Uddin Syed-Abdullah1,Roma Katerina2,Ross Lindsey1,Hanna George1,Drazin Doniel2,Kim Terrence T.3

Affiliation:

1. Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California,

2. Department of Neurosurgery, Pacific Northwest University of Health Sciences, Yakima, Washington,

3. Cedars-Sinai Medical Center, Spine Center, Los Angeles, California, United States.

Abstract

Background: Dabigatran is an anticoagulant (novel oral anticoagulant) that is a direct thrombin inhibitor and only recently has a reversal agent, idarucizumab, been made available (2015). Case Description: An 86-year-old male taking dabigatran for atrial fibrillation, acutely presented with the spontaneous onset of neck pain and quadriparesis. When the MRI demonstrated a C2-T2 spinal epidural hematoma, the patient was given the reversal agent idarucizumab. Due to his attendant major comorbidities, he was managed nonoperatively. Over the next 7 days, the patient’s neurological deficits resolved, and within 2 weeks, he had regained normal neurological function. Conclusion: In this case, a C2-T2 epidural cervical hematoma attributed to dabigatran that was responsible for an acute, spontaneous quadriparesis was successfully treated with the reversal agent idarucizumab without surgical intervention being warranted.

Publisher

Scientific Scholar

Subject

Neurology (clinical),Surgery

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