Iwasaki Motoyuki, Echizenya Ikuma, Fujimura Miki
Department of Neurosurgery, Hokkaido University, Sapporo, Hokkaido, Japan.
NMC Case Rep J. 2024 Jul 27;11:207-211. doi: 10.2176/jns-nmc.2024-0002. eCollection 2024.
Hematomyelia associated with direct oral anticoagulants (DOACs) is rare. In this report, a case of a 78-year-old male with paraplegia due to hematomyelia after medication of rivaroxaban, which is the first case in which acute renal failure is closely associated with the onset and underwent surgical evacuation is presented. The patient was initially misdiagnosed as a spinal cord infarction, and appropriate therapeutic intervention was not provided. One year later, the patient's symptoms did not improve, he is dependent on a wheelchair for daily activities, and cystostomy was performed. During administration of DOACs, hemorrhagic lesion should be strongly suspected in a patient with acute renal failure.
与直接口服抗凝剂(DOACs)相关的脊髓出血很罕见。在本报告中,介绍了一例78岁男性,在服用利伐沙班后因脊髓出血导致截瘫,这是首例急性肾衰竭与发病密切相关且接受手术清除血肿的病例。该患者最初被误诊为脊髓梗死,未得到适当的治疗干预。一年后,患者症状未改善,日常生活依赖轮椅,并进行了膀胱造瘘术。在使用DOACs期间,急性肾衰竭患者应高度怀疑有出血性病变。