Vayá A, Resurección M, Ricart J M, Ortuño C, Ripoll F, Mira Y, Aznar J
Department of Clinical Pathology, La Fe University Hospital, Valencia, Spain.
Clin Appl Thromb Hemost. 2001 Apr;7(2):166-8. doi: 10.1177/107602960100700215.
A 54-year-old woman who was on anticoagulant treatment with acenocoumarol for a mitral prothesis developed a cervical spinal epidural hematoma, probably triggered by coughing fits together with supratherapeutic anticoagulation. Because of the subacute evolution of the hematoma, it was not diagnosed until the patient was admitted to the hospital with profuse hemorrhages. Given the subacute nature of the hematoma, along with the favorable evolution, conservative treatment with dexamethasone was decided upon, and it was resolved with almost no sequelae. This unusual clinical entity definitely should be suspected in patients on anticoagulants who complain of severe localized neck pain, most often with radicular irradiation.
一名54岁女性因二尖瓣人工瓣膜使用醋硝香豆素进行抗凝治疗，发生了颈段脊髓硬膜外血肿，可能是咳嗽发作与抗凝治疗剂量超过治疗范围共同引发的。由于血肿呈亚急性进展，直到患者因大量出血入院才被诊断出来。鉴于血肿的亚急性性质以及良好的病情进展，决定采用地塞米松进行保守治疗，且几乎未留下后遗症。对于服用抗凝剂且主诉严重局限性颈部疼痛（多数伴有神经根放射痛）的患者，绝对应怀疑这种不常见的临床病症。
