Spontaneous Cervical Epidural Hematoma in a Patient on Anticoagulant Therapy – Therapeutic Approach

Introduction: Spontaneous cervical epidural hematoma is an uncommon cause of acute spinal cord compression. This is a rare idiopathic condition that should be considered in non-traumatic patients with acute onset of neurological deficits, which if not recognized early can have catastrophic consequences. Objective: Trought a case report of a patient with epidural hematoma, to present the consequences of anticoagulant therapy and the therapeutic approach with neuroprotective supplements (NurAid) that can lead to neurological improvement and rehabilitation. Case report: A 68-year-old male patient with a history of hypertension, atrial fibrillation, and previous interventional cardiology procedures is transported with acute quadriplegia, severe headache, arterial hypertension and Glasgow Coma Scale score of 15. After the patient underwent a comprehensive neurological and neurosurgical evaluation, which lead to diagnose an epidural hematoma at the C3/C4 level and paraplegia. The patient is hospitalized and is prescribed anticoagulant, neuroprotective, anti-hypertensive and supportive therapy. Results: Although the neuroprotective supplement (NurAid) doesn’t have a direct therapeutic effect on epidural hematomas and does not influence coagulation status, its role is supportive, particularly in facilitating neurological recovery process. Conclusion: In patients on anticoagulant therapy, acute epidural hematoma may occur because of prolongated use of anticoagulants. The neuroprotective therapy (with NurAid) has a significant role with faster and easier neurological recovery. Keywords: epidural hematoma, neuroprotective, anticoagulant.