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J Neurol Surg A Cent Eur Neurosurg 2023; 84(02): 212-215
DOI: 10.1055/s-0041-1728768
Case Report

Spontaneous Hematomyelia Associated with the Use of Non–vitamin K Antagonist

Moon Soo Park 
1   Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, Gyeonggi-do, Republic of Korea
,
Seong-Hwan Moon
2   Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Seung Bo Jang
1   Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, Gyeonggi-do, Republic of Korea
,
Jeoung Woo Kim
1   Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, Gyeonggi-do, Republic of Korea
,
Paul S. Sung
3   Doctoral Program in Physical Therapy, The Herbert H. and Grace A. Dow College of Health Professions, Central Michigan University, Mount Pleasant, Michigan, United States
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Abstract

Vitamin K antagonists have been frequently prescribed as anticoagulants with the potential side effect of spontaneous hematomyelia with a poor prognosis. However, to our knowledge, there has been no report of spontaneous hematomyelia combined with the use of a non–vitamin K antagonist. A 63-year-old man presented with left leg weakness, impaired sensation, and urinary retention while taking rivaroxaban (non–vitamin K antagonist) for 4 months for atrial fibrillation. Anticoagulant agents were discontinued. Methylprednisolone pulse therapy was administered without surgical hematoma evacuation. Three months after the initial development of the hematomyelia, the symptoms improved to grade 5 for both lower extremities, and there was complete recovery in sensory and urinary functions. This might be the first description of a complete recovery of neurologic deficits without hematoma evacuation in spontaneous hematomyelia patients caused by non–vitamin K antagonist therapy.

Keywords

anticoagulant - rivaroxaban - spinal intramedullary hematoma


Publication History

Received: 25 April 2020

Accepted: 26 November 2020

Article published online:
14 June 2021

© 2021. Thieme. All rights reserved.

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