Spontaneous spinal epidural hematoma. Another neurologic complication of cocaine?

OBJECTIVES To describe a patient with a spontaneous spinal epidural hematoma associated with cocaine use and to present issues related to pathogenesis and management of this potential complication. DESIGN Case report. SETTING Municipal hospital. CASE A spontaneous spinal epidural hematoma developed at the thoracic level in a 62-year-old man in association with cocaine use. Clinical, laboratory, and radiologic data are presented. MAIN OUTCOME AND RESULTS The patient was treated medically with intravenous and oral dexamethasone sodium phosphate. His neurologic status gradually improved during a 12-day hospitalization. CONCLUSION Cocaine use should be considered in the evaluation of spontaneous spinal epidural hemorrhage.

[1]  B. Koppel,et al.  Neurovascular complications of cocaine , 1994, Acta neurologica Scandinavica.

[2]  J. Huff.  Spinal epidural hematoma associated with cocaine abuse. , 1994, The American journal of emergency medicine.

[3]  S. Saito,et al.  Spinal epidural hematoma with spontaneous recovery demonstrated by magnetic resonance imaging. , 1994, Spine.

[4]  A. Fortuna,et al.  Spontaneous spinal epidural hematoma: Pre-operative diagnosis by MRI , 1990, Clinical Neurology and Neurosurgery.

[5]  N. Colombo,et al.  Value of magnetic resonance imaging in spontaneous extradural spinal hematoma due to vascular malformation: case report. , 1990, Surgical neurology.

[6]  R. Groen,et al.  The spontaneous spinal epidural hematoma A study of the etiology , 1990, Journal of the Neurological Sciences.

[7]  R. Weiss,et al.  Protracted elimination of cocaine metabolites in long-term high-dose cocaine abusers. , 1988, The American journal of medicine.

[8]  M. Goldberg,et al.  Neurologic complications of cocaine abuse , 1988, Neurology.

[9]  H. Mattle,et al.  Nontraumatic spinal epidural and subdural hematomas , 1987, Neurology.

[10]  R. Baselt,et al.  Urinary excretion of cocaine and benzoylecgonine following oral ingestion in a single subject. , 1987, Journal of analytical toxicology.

[11]  A. Rossier,et al.  Preoperative neurological status in predicting surgical outcome of spinal epidural hematomas. , 1981, Surgical neurology.

[12]  J. Ainslie.  Paraplegia due to spontaneous extradural or subdural hæmorrhage , 1958, The British journal of surgery.

[13]  C. Clarke,et al.  Successful conservative management of spontaneous spinal extradural haematoma. , 1993, British journal of neurosurgery.

[14]  G. Bertrand,et al.  Spontaneous spinal epidural hematoma causing paraplegia: resolution and recovery without surgical decompression. , 1992, Neurosurgery.