PMID- 32140027
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 0976-3147 (Print)
IS  - 0976-3155 (Electronic)
IS  - 0976-3155 (Linking)
VI  - 11
IP  - 1
DP  - 2020 Jan
TI  - Spontaneous Epidural Hematoma of the Cervical Spine Following Thrombolysis in a 
      Patient with STEMI-Two Medical Specialties Facing a Rare Dilemma.
PG  - 191-195
LID - 10.1055/s-0039-3400182 [doi]
AB  - Spontaneous spinal epidural hematoma (SSEH) is a rare, albeit well-documented 
      complication following thrombolysis treatment in ST elevation myocardial 
      infarction (STEMI). A SSEH usually manifests with cervical pain and neurologic 
      deficits and may require surgical intervention. In this case report, we present 
      the first reported SSEH to occur following thrombolysis with reteplase. In this 
      case, the SSEH manifested with cervical pain shortly after the patient emerged 
      from his rescue percutaneous coronary intervention (PCI). Although magnetic 
      resonance imaging reported spinal cord compression, the lack of neurologic 
      symptoms prompted the treating clinicians to delay surgery. A dangerous dilemma 
      emerged, as the usual antithrombotic regimen that was necessary to avoid stent 
      thrombosis post-PCI, was also likely to exacerbate the bleeding. As a compromise, 
      the patient only received aspirin as a single antiplatelet therapy. Ultimately, 
      the patient responded well to conservative treatment, with the hematoma 
      stabilizing a week later, without residual neurologic deficits. In conclusion, 
      the conservative treatment of SSEH appears to be an acceptable option for 
      carefully selected patients, but the risks of permanent neurologic deficits and 
      stent thrombosis have to be weighted for each patient.
FAU - Tsarouchas, Anastasios
AU  - Tsarouchas A
AD  - 3rd Cardiology Department, Hippokrateio University Hospital, Aristotle University 
      of Thessaloniki, Thessaloniki, Greece.
FAU - Mouselimis, Dimitrios
AU  - Mouselimis D
AD  - 3rd Cardiology Department, Hippokrateio University Hospital, Aristotle University 
      of Thessaloniki, Thessaloniki, Greece.
FAU - Bakogiannis, Constantinos
AU  - Bakogiannis C
AD  - 3rd Cardiology Department, Hippokrateio University Hospital, Aristotle University 
      of Thessaloniki, Thessaloniki, Greece.
FAU - Gkasdaris, Grigorios
AU  - Gkasdaris G
AD  - Department of Neurosurgery, KAT General Hospital of Attica, Athens, Greece.
FAU - Dimitriadis, George
AU  - Dimitriadis G
AD  - General Hospital of Katerini, Katerini, Greece.
FAU - Zioutas, Dimitrios
AU  - Zioutas D
AD  - St. Luke's Hospital, Thessaloniki, Greece.
FAU - Papadopoulos, Christodoulos E
AU  - Papadopoulos CE
AD  - 3rd Cardiology Department, Hippokrateio University Hospital, Aristotle University 
      of Thessaloniki, Thessaloniki, Greece.
LA  - eng
PT  - Case Reports
DEP - 20191205
PL  - United States
TA  - J Neurosci Rural Pract
JT  - Journal of neurosciences in rural practice
JID - 101533710
PMC - PMC7055631
OTO - NOTNLM
OT  - ST elevation myocardial infarction
OT  - cervical spine
OT  - spinal epidural hematoma
OT  - spontaneous spinal epidural hematoma
OT  - thrombolysis
COIS- Conflict of Interest None declared.
EDAT- 2020/03/07 06:00
MHDA- 2020/03/07 06:01
PMCR- 2020/01/01
CRDT- 2020/03/07 06:00
PHST- 2020/03/07 06:00 [entrez]
PHST- 2020/03/07 06:00 [pubmed]
PHST- 2020/03/07 06:01 [medline]
PHST- 2020/01/01 00:00 [pmc-release]
AID - JNRP1900212 [pii]
AID - 10.1055/s-0039-3400182 [doi]
PST - ppublish
SO  - J Neurosci Rural Pract. 2020 Jan;11(1):191-195. doi: 10.1055/s-0039-3400182. Epub 
      2019 Dec 5.