Management of acute non-traumatic intradural spinal hematoma associated with oral anti-coagulant and anti-aggregant therapy: Case report and review of literature [Antikoagülan tedavi sonrası gelişen nontravmatik İntradural spinal hematom: Olgu sunumu ve literatürün gözden geçirilmesi]

Most of the non-traumatic spinal hematomas are epidural hematomas and reported less than 1% in literature. intra-dural non-traumatic spinal hematomas are even more rare pathologies. a 55-years-old man admitted with the complaints of vertigo and left hemi-hypoesthesia. mri findings revealed left cerebellar,left parieto-occipital diffusion restriction and dissection of left cervical segment of internal carotid artery and patient was treated with anticoagulant and anti-aggregant therapy. during anticoagulant and anti-aggregant therapy sudden onset paraparasia with motor strength 2/5 was developed. urgent throco-lumbar mri revealed intra-dural acute hematoma at t12-l5 levels. the patient immediately underwent decompressive t11-t12-l1-l2-l3-l4-l5 total laminectomy,intra-dural rigid hematoma drainage and posterior instrumentation with duraplasty. the patient was discharged with motor strength 4/5 bilaterally on the 15th day of operation. to our knowledge present case is the longest segmental intradural non-traumatic spinal hematoma in the literature that underwent decompressive and stabilization surgery. non-traumatic spinal intradural hematomas (ntsidh) are extremely rare. urgent decompressive surgery is gold standard for patients with progressive neurologic deficits. © 2015,ege university press. all rights reserved.