Warfarin Induced Spontaneous Cranial Epidural Hematoma: A Case Report And Review Of The Literature

Ustundag, M.; Sayhan, M. B.; Gokhan, S.; Orak, M.; Gokdemir, M. T.
October 2009
Internet Journal of Emergency Medicine;Oct2009, Vol. 6 Issue 1, p7
Academic Journal
Case Study
Introduction: Epidural haematomas are almost always traumatic in origin. The occurrence of spontaneous cranial epidural hematoma (SCEH) is rare and its incidence is not known. In literature scanning; two cases of non-traumatic SCEH has been reported, but no case of warfarin induced SCEH has been reported. We want to attract attention to a case which cannot be seen in literature scanning: SCEH caused by warfarin. Case: A 76-year-old woman applied to our emergency room with suddenly depressed consciousness level. There were no external signs of any trauma to the scalp or face and there was no previous history of any trauma. She had undergone cardio embolic stroke ten years before. She had been taking warfarin. Computed tomography of the brain revealed bilateral chronic subdural effusions with a large left temporal epidural haematoma but no evidence of skull fracture or cephalohaematoma.Conclusion: Long-term anticoagulant drug therapy may cause spontaneous epidural haematoma. Many clinicians continue to perceive that older persons who are at increased risk of falling have an unacceptably high risk of antithrombotic-related major hemorrhage.


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