Spontaneous spinal epidural haematoma associated with aspirin intake

Oh JYL, Lingaraj K, Rahmat R
Correspondence: Dr Jacob Yoong-Leong Oh, jacob_oh@yahoo.com

ABSTRACT
Spontaneous spinal epidural haematoma (SSEH) is rare. No identifiable cause is found in the majority of cases, while anticoagulation accounts for up to 17 percent of cases. Aspirin-associated SSEH, however, has rarely been described in literature. A 62-year-old man on prophylactic aspirin presented with symptoms of acute cord compression due to spinal epidural haematoma that was confirmed on magnetic resonance imaging. An emergency decompression laminectomy was performed ten hours after the onset of his symptoms. No vascular anomaly was detected. Our patient recovered well and regained full motor and sensory function. Aspirin is unlikely to be the direct cause of SSEH but may predispose to it, with the underlying cause being a locus minoris resistentiae, consisting of a network of weakened epidural veins. Early diagnosis and treatment are essential for a successful outcome.

Keywords: acute spinal cord compression, aspirin-associated spontaneous spinal epidural haematoma, aspirin complication, cord compression, spinal emergency, spontaneous spinal epidural haematoma
Singapore Med J 2008; 49(12): e353-e355