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European Spine Journal

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01-05-2016 | Case Report

Nontraumatic spinal subdural hematoma complicating direct factor Xa inhibitor treatment (rivaroxaban): a challenging management

Authors: Cyril Dargazanli, Nicolas Lonjon, Guillaume Gras-Combe

Published in: European Spine Journal | Special Issue 1/2016

Abstract

Purpose

We report on a 72-year-old male patient who developed a nontraumatic spinal subdural hematoma (SSDH) during rivaroxaban therapy, a relatively new orally administered direct factor Xa inhibitor.

Case description

The patient sustained a sudden onset of interscapular pain, followed by gait impairment and paraplegia. Magnetic resonance imaging (MRI) of the spine demonstrated SSDH from T6 to T8. Laboratory tests revealed a high rivaroxaban level, associated with a major hemorrhagic risk. Surgery was, therefore, performed the following morning, after normalization of coagulation parameters.

Conclusion

Determining the time of safe surgery remains challenging when hemorrhagic complications happen with direct factor Xa inhibitor, especially when neurological prognosis is engaged. Spinal subdural hematoma has not previously been reported following rivaroxaban therapy.

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Title: Nontraumatic spinal subdural hematoma complicating direct factor Xa inhibitor treatment (rivaroxaban): a challenging management
Authors: Cyril Dargazanli
Nicolas Lonjon
Guillaume Gras-Combe
Publication date: 01-05-2016
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue Special Issue 1/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-015-4160-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Nontraumatic spinal subdural hematoma complicating direct factor Xa inhibitor treatment (rivaroxaban): a challenging management

Abstract

Purpose

Case description

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Case description

Conclusion

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