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Spinal Subdural or Epidural Hematoma
A spinal subdural or epidural hematoma is an accumulation of blood in the subdural or epidural space that can mechanically compress the spinal cord.
Spinal subdural or epidural hematoma (usually thoracic or lumbar) is rare but may result from back trauma, anticoagulant or thrombolytic therapy, or, in patients with bleeding diatheses, lumbar puncture.
Treatment is immediate surgical drainage. Patients taking coumarin anticoagulants are given phytonadione (vitamin K 1 ) 2.5 to 10 mg sc and fresh frozen plasma as needed to normalize INR. Patients with thrombocytopenia are given platelets (see Platelets).
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