Rivaroxaban-induced acute cervical spine epidural hematoma: Report of a case and review

Abolfazl Rahimizadeh; Zahed Malekmohammadi; Walter L Williamson; Shaghayegh Rahimizadeh; Mahan Amirzadeh; Naser Asgari

doi:10.25259/SNI_390_2019

Rivaroxaban-induced acute cervical spine epidural hematoma: Report of a case and review

Surg Neurol Int. 2019 Oct 25:10:210. doi: 10.25259/SNI_390_2019. eCollection 2019.

Authors

Abolfazl Rahimizadeh¹, Zahed Malekmohammadi¹, Walter L Williamson¹, Shaghayegh Rahimizadeh¹, Mahan Amirzadeh¹, Naser Asgari¹

Affiliation

¹ Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran.

Abstract

Background: Spontaneous spinal epidural hematomas (SEHs) due to the utilization of factor Xa inhibitors are rare.

Case description: A 66-year-old female presented with a Brown-Sequard syndrome attributed to a cervical epidural hematoma secondary to the utilization of rivaroxaban, one of the factor Xa inhibitors. Following a cervical laminectomy for the evacuation of the hematoma, the patient completely recovered.

Conclusion: A spinal hemorrhagic event should be suspected in patients receiving factor Xa inhibitor drugs. Here, we had an elderly female on rivaroxaban experienced the acute onset of neck/back pain associated with a Brown-Sequard syndrome. A literature review showed that this is the seventh example of SEH occurring as a result of the use of anticoagulation drugs (OACDs; e.g., including Xa inhibitors).

Keywords: Anticoagulant; Factor Xa inhibitors; Rivaroxaban; Spinal epidural hematoma.

Publication types

Case Reports